Organization
VANESSA PERO MEDICAL DIAGNOSTIC SERVICES PC
Active
Organization
VANESSA PERO MEDICAL DIAGNOSTIC SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VANESSA THERESA THERESA MD (OWNER)
(718) 267-8196
Entity
Organization
Contact information
Practice address
458 MAIN ST, PORT WASHINGTON, NY 11050-3123
(718) 267-8196
Mailing address
365 MINEOLA BLVD, MINEOLA, NY 11501-1526
(718) 267-8196
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
167430
NY
2085R0202X
Diagnostic Radiology Physician
Primary
167342
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174734859
INDIVIDUAL NPI
NY
Enumeration date
05/24/2007
Last updated
09/11/2025
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