| Perez Neuropsychology | |
|
2355 Highway 36 W Ste 400 Roseville MN 55113-3905 | |
| (856) 332-4869 | |
| (855) 708-5583 |
| Full Name | Perez Neuropsychology |
|---|---|
| Speciality | Psychologist |
| Location | 2355 Highway 36 W Ste 400, Roseville, Minnesota |
| Authorized Official Name and Position | Leslie Perez (OWNER) |
| Authorized Official Contact | 8563324869 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Perez Neuropsychology 401 S 1st St Unit 1018 Minneapolis MN 55401-2567 Ph: (856) 332-4869 | Perez Neuropsychology 2355 Highway 36 W Ste 400 Roseville MN 55113-3905 Ph: (856) 332-4869 |
| NPI Number | 1073379293 |
|---|---|
| Provider Enumeration Date | 02/26/2024 |
| Last Update Date | 04/23/2024 |
| Certification Date | 04/23/2024 |
| Medicare PECOS PAC ID | 3173964293 |
|---|---|
| Medicare Enrollment ID | O20240507002890 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073379293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Leslie N Perez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104476589 PECOS PAC ID: 4981030855 Enrollment ID: I20200213000131 |
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