Individual
OCTAVIA PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
160 N MIDLAND AVE, NYACK, NY 10960-1912
(845) 348-2000
Mailing address
454 AVALON GARDENS DR, NANUET, NY 10954-7434
(803) 917-4815
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024175789
VA
363L00000X
Nurse Practitioner
Primary
21238
SC
363LF0000X
Family Nurse Practitioner
344839
NY
Other
Enumeration date
11/15/2018
Last updated
09/24/2019
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