Provider Demographics
NPI:1629387493
Name:PERRI, NICOLE ELISE (MSSPED)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:ELISE
Last Name:PERRI
Suffix:
Gender:F
Credentials:MSSPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MORGAN CT
Mailing Address - Street 2:
Mailing Address - City:CENTRAL VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10917-3525
Mailing Address - Country:US
Mailing Address - Phone:718-710-0917
Mailing Address - Fax:
Practice Address - Street 1:87 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTONVILLE
Practice Address - State:NY
Practice Address - Zip Code:10992-1279
Practice Address - Country:US
Practice Address - Phone:845-495-0517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist