Provider Demographics
NPI:1154634913
Name:PERLMUTTER KALINA, MARSHA (PHD)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:PERLMUTTER KALINA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARSHA
Other - Middle Name:A
Other - Last Name:PERLMUTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:303 MERRICK RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2501
Mailing Address - Country:US
Mailing Address - Phone:800-725-6280
Mailing Address - Fax:800-725-6380
Practice Address - Street 1:27111 76TH AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1436
Practice Address - Country:US
Practice Address - Phone:718-289-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018258103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical