Provider Demographics
NPI:1275641722
Name:PERKINS, GREGORY NORMAN (PT)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:NORMAN
Last Name:PERKINS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 JEFFERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-3850
Mailing Address - Country:US
Mailing Address - Phone:401-463-3060
Mailing Address - Fax:401-463-9990
Practice Address - Street 1:100 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-3850
Practice Address - Country:US
Practice Address - Phone:401-463-3060
Practice Address - Fax:401-463-9990
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI642225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI6400223OtherUNITED
RI75428OtherBLUE CROSS
RI402474OtherBLUE CHIP