Provider Demographics
NPI:1114089786
Name:PERL, HAROLD IRA (PHD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:IRA
Last Name:PERL
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 1:5816 OSCEOLA RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2033
Mailing Address - Country:US
Mailing Address - Phone:301-320-6383
Mailing Address - Fax:301-320-6383
Practice Address - Street 1:4829 WEST LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-5317
Practice Address - Country:US
Practice Address - Phone:301-320-6383
Practice Address - Fax:301-907-6948
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02425103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD491769Medicare ID - Type Unspecified