Individual
JAMES PERALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
80 SHARRON AVE, PLATTSBURGH, NY 12901-4700
(518) 561-1447
Mailing address
79 GLENRIDGE RD, GLENVILLE, NY 12302-4523
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
35886
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420800
—
NY
Enumeration date
04/03/2020
Last updated
04/03/2020
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