Provider Demographics
NPI:1164537585
Name:PERL, JOSEPH L (PHD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:L
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 1:7 TALBOT DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12569-7624
Mailing Address - Country:US
Mailing Address - Phone:845-635-8224
Mailing Address - Fax:845-635-1109
Practice Address - Street 1:1732 MAIN ST
Practice Address - Street 2:
Practice Address - City:PLEASANT VALLEY
Practice Address - State:NY
Practice Address - Zip Code:12569-5611
Practice Address - Country:US
Practice Address - Phone:845-635-8224
Practice Address - Fax:845-635-1109
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0067161103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
5753308OtherAETNA
000471244001OtherBCNENY
027415OtherVALUE OPTIONS
87941OtherCIGNA BEH HEALTH
007641000OtherMAGELLAN
6803296OtherVALUE OPTIONS
1033150OtherBEACON HEALTH STRAT
954895OtherMVP HEALTH CARE
5753308OtherAETNA
6803296OtherVALUE OPTIONS