Provider Demographics
NPI:1114368370
Name:PEARLMAN, SHOSHANNAH (NP)
Entity Type:Individual
Prefix:MS
First Name:SHOSHANNAH
Middle Name:
Last Name:PEARLMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 MADISON AVENUE
Mailing Address - Street 2:SUITE 1130
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:516-418-6298
Mailing Address - Fax:646-607-5196
Practice Address - Street 1:149 MADISON AVENUE
Practice Address - Street 2:SUITE 1130
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:516-418-6298
Practice Address - Fax:646-607-5196
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY643272-1163W00000X
NYF401644363LP0808X
NY643272163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse