Provider Demographics
NPI:1609879147
Name:PERLOW, STEVEN (AUD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:PERLOW
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6645 MAIN STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-633-0721
Mailing Address - Fax:716-633-5987
Practice Address - Street 1:6645 MAIN STREET
Practice Address - Street 2:SUITE B
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-633-0721
Practice Address - Fax:716-633-5987
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-28
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY506231H00000X, 231HA2400X, 231HA2500X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000576036001OtherSEN. BLUE - STEVE
NY000580017401OtherSEN. BLUE - ACCURA
NY000580074001OtherCB TRAD. - ACCURA
NY9210640OtherIHA
NY000576036001OtherBC TRAD. - STEVE
NY000576036001OtherCB
NY000580074001OtherBC/GM - ACCURA
NY02149984Medicaid
NY00011175601OtherUNIVERA INCL. SEN. CHOICE
NY02149984Medicaid
NY000576036001OtherSEN. BLUE - STEVE