Provider Demographics
NPI:1487993259
Name:PERATE, SYDNEY M (MS)
Entity type:Individual
Prefix:MS
First Name:SYDNEY
Middle Name:M
Last Name:PERATE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1642
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82931-1642
Mailing Address - Country:US
Mailing Address - Phone:307-789-0664
Mailing Address - Fax:
Practice Address - Street 1:1425 HIGHWAY 150 S
Practice Address - Street 2:SUITE 2
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930-5377
Practice Address - Country:US
Practice Address - Phone:307-789-0664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator