Individual
DR. JEFFREY ANTHONY DE PERIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
571 TERRACE BLVD, DEPEW, NY 14043-3610
(716) 683-6737
(716) 683-5463
Mailing address
571 TERRACE BLVD, DEPEW, NY 14043-3610
(716) 683-6737
(716) 683-5463
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
196887-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01604553
—
NY
Enumeration date
04/04/2006
Last updated
03/26/2010
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