Provider Demographics
NPI:1578130332
Name:PERLMAN, EVON MARIE
Entity Type:Individual
Prefix:MRS
First Name:EVON
Middle Name:MARIE
Last Name:PERLMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-2557
Mailing Address - Country:US
Mailing Address - Phone:203-631-5452
Mailing Address - Fax:
Practice Address - Street 1:599 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2356
Practice Address - Country:US
Practice Address - Phone:860-837-9676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician