Provider Demographics
NPI:1669471470
Name:PERL, DANIEL PETER (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:PETER
Last Name:PERL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:PATHOLOGY, BOX 1194
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6500
Mailing Address - Country:US
Mailing Address - Phone:212-241-9117
Mailing Address - Fax:212-996-1343
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:PATHOLOGY, BOX 1194
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6500
Practice Address - Country:US
Practice Address - Phone:212-731-7771
Practice Address - Fax:212-534-7491
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2009-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY104834207ZN0500X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA61017Medicare UPIN
NY18E141Medicare ID - Type Unspecified