Provider Demographics
NPI:1245242395
Name:PEARLMAN, ROBERT (P-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:PEARLMAN
Suffix:
Gender:M
Credentials:P-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 BATTEY MEETINGHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1910
Mailing Address - Country:US
Mailing Address - Phone:401-647-2421
Mailing Address - Fax:509-851-0188
Practice Address - Street 1:725 RESERVOIR AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-4448
Practice Address - Country:US
Practice Address - Phone:401-943-5120
Practice Address - Fax:401-942-3790
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA 00013363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP84778Medicare UPIN