Individual
MARIO PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 JEFFERSON SQ, WATERBURY, CT 06706-1109
(203) 709-6200
(203) 709-3335
Mailing address
56 FRANKLIN ST, 3RD FLOOR, WATERBURY, CT 06706-1221
(203) 709-8873
(203) 709-8689
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
015531
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001155317
—
CT
Enumeration date
06/28/2006
Last updated
09/12/2007
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