Provider Demographics
NPI:1225198898
Name:PERLINE, SHELLEY BROOK (DC)
Entity Type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:BROOK
Last Name:PERLINE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 3RD AVE
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3627
Mailing Address - Country:US
Mailing Address - Phone:212-371-0700
Mailing Address - Fax:212-750-9114
Practice Address - Street 1:920 3RD AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3627
Practice Address - Country:US
Practice Address - Phone:212-371-0700
Practice Address - Fax:212-750-9114
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0100851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX6V56OtherEMPIRE BCBS
NYP3006366OtherOXFORD
NYX6V56OtherEMPIRE BCBS
NYX6V56OtherEMPIRE BCBS