Provider Demographics
NPI:1629089743
Name:PERINPANAYAGAM, NOEL I (MD)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:I
Last Name:PERINPANAYAGAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NOEL
Other - Middle Name:I
Other - Last Name:PERIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:530 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:530 1ST AVE
Practice Address - Street 2:SUITE 8S
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-5732
Practice Address - Fax:212-263-5328
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1741831207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01522178Medicaid
NY01522178Medicaid
NY25J901Medicare ID - Type Unspecified