Provider Demographics
NPI:1043547235
Name:PERRONE, JAMES (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:PERRONE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 WHEELER RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-2420
Mailing Address - Country:US
Mailing Address - Phone:203-452-7670
Mailing Address - Fax:
Practice Address - Street 1:23 WHEELER RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-2420
Practice Address - Country:US
Practice Address - Phone:203-452-7670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4272103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist