Provider Demographics
NPI:1346528395
Name:PERRINI, CAROL (MSED)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:
Last Name:PERRINI
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 BEACH 149TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1026
Mailing Address - Country:US
Mailing Address - Phone:646-642-7226
Mailing Address - Fax:
Practice Address - Street 1:331 BEACH 149TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11694-1026
Practice Address - Country:US
Practice Address - Phone:646-642-7226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
NY174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator