Individual
MICHAEL JOSEPH PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
1400 NOYES ST, UTICA, NY 13502-3854
(315) 738-4075
(907) 260-3697
Mailing address
995 BEAVER CREEK RD, WATERVILLE, NY 13480-2403
(315) 737-1542
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1478
AK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401302
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
F401302-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619189
—
AK
Enumeration date
10/15/2010
Last updated
06/13/2024
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