Provider Demographics
NPI:1326062597
Name:PERLIN, MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:
Last Name:PERLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N BEDFORD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2555
Mailing Address - Country:US
Mailing Address - Phone:203-856-0185
Mailing Address - Fax:203-866-5594
Practice Address - Street 1:118 N BEDFORD RD STE 100
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2555
Practice Address - Country:US
Practice Address - Phone:203-856-0185
Practice Address - Fax:203-866-5594
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT030601207R00000X
NY131163207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00747484Medicaid
NY1306019Medicaid
CT1306019Medicaid