Organization
HEALTH DEVELOPMENT & RESTORATIVE MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREA PEREZ D.O. (PRESIDENT)
(631) 682-5163
Entity
Organization
Contact information
Practice address
1469 BEACH AVE, MEDICAL OFFICE, BRONX, NY 10460-3630
(347) 810-9001
Mailing address
1469 BEACH AVE, MEDICAL OFFICE, BRONX, NY 10460-3630
(347) 810-9001
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
133N00000X
Nutritionist
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
—
—
207Q00000X
Family Medicine Physician
Primary
231817
NY
213E00000X
Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A100017863
MEDICARE PTAN
NY
Enumeration date
05/28/2009
Last updated
07/01/2015
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