Provider Demographics
NPI:1093892465
Name:PERIN, PATRICK V (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:V
Last Name:PERIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:553 CEDAR LN STE A
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-1712
Practice Address - Country:US
Practice Address - Phone:201-836-6400
Practice Address - Fax:201-836-0399
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05507300207K00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0431711Medicaid
NJ651311ZKRPOtherMEDICARE PTAN
NJ651311Medicare PIN