Provider Demographics
NPI:1083622088
Name:PERRICK, STEVEN L (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:L
Last Name:PERRICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 OLD COUNTRY ROAD
Mailing Address - Street 2:STE 1B
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590
Mailing Address - Country:US
Mailing Address - Phone:516-333-7272
Mailing Address - Fax:516-333-2519
Practice Address - Street 1:530 OLD COUNTRY ROAD
Practice Address - Street 2:STE 1B
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590
Practice Address - Country:US
Practice Address - Phone:516-333-7272
Practice Address - Fax:516-333-2519
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY152412208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY010152412OtherANTHEM
1000015358OtherAFFINITY
9786625002OtherCIGNA
0780SPOtherPRIS
30128460OtherFIDELIS
3C6478OtherHEALTHNET
93594OtherVYTRA
P1280410OtherOXFORD
152412A27OtherHEALTHFIRST
771484OtherHERITAGE ADVANTAGE
000000055633OtherGHI
176215315530830OtherFIRST HEALTH
2154018OtherUSH
393479OtherUH
7895093OtherHIP
AA50765OtherNDNY
91A751OtherBCBS
3627OtherPIN
AP1962338OtherDEA
91A751OtherBCBS