Provider Demographics
NPI:1538134838
Name:PERRY, JOSEPH P (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:P
Last Name:PERRY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 S MAIN ST
Mailing Address - Street 2:SUITE 305B
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5370
Mailing Address - Country:US
Mailing Address - Phone:412-832-3851
Mailing Address - Fax:412-832-9201
Practice Address - Street 1:1225 S MAIN ST
Practice Address - Street 2:SUITE 305B
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5370
Practice Address - Country:US
Practice Address - Phone:412-832-3851
Practice Address - Fax:412-832-9201
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007165L103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAR006016Medicare UPIN
PA092918Medicare ID - Type UnspecifiedMEDICARE