Provider Demographics
NPI:1275582314
Name:PERLIS, MARIA F (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:F
Last Name:PERLIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:FACCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:734 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2176
Mailing Address - Country:US
Mailing Address - Phone:717-295-2323
Mailing Address - Fax:717-295-7294
Practice Address - Street 1:734 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2176
Practice Address - Country:US
Practice Address - Phone:717-295-2323
Practice Address - Fax:717-295-7294
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD060852L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016502240002Medicaid
PA158841OtherMEDICARE GROPU NUMBER
001599F8RMedicare PIN
PAG59256Medicare UPIN