Provider Demographics
NPI:1760713358
Name:PEREZ, JAZZELINE NICOLE (DPT)
Entity type:Individual
Prefix:DR
First Name:JAZZELINE
Middle Name:NICOLE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 STRAWBERRY HILL AVE
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2681
Mailing Address - Country:US
Mailing Address - Phone:203-516-0953
Mailing Address - Fax:203-763-1744
Practice Address - Street 1:31 STRAWBERRY HILL AVE
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2681
Practice Address - Country:US
Practice Address - Phone:203-516-0953
Practice Address - Fax:203-763-1744
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2025-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT008612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist