Provider Demographics
NPI:1427032846
Name:PERLOV, NATALYA (PT)
Entity Type:Individual
Prefix:MRS
First Name:NATALYA
Middle Name:
Last Name:PERLOV
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 TAINTOR DR
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-1267
Mailing Address - Country:US
Mailing Address - Phone:201-417-3776
Mailing Address - Fax:
Practice Address - Street 1:22 TAINTOR DR
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-1267
Practice Address - Country:US
Practice Address - Phone:201-417-3776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21398225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ060C10Medicare ID - Type Unspecified
NJ085136BPVMedicare ID - Type Unspecified