Individual
MS. TANYA MONIQUE PEREZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
11050 MOUNT BELVEDERE BLVD, USA MEDDAC/CREDENTIALS, FORT DRUM, NY 13602-5438
(315) 772-4025
(315) 772-9498
Mailing address
436 BROADWAY AVE E, WATERTOWN, NY 13601-3828
(315) 681-6645
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
01/05/2006
Last updated
07/08/2007
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