Provider Demographics
NPI:1689260077
Name:PERL, SHIRI C (LPN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:SHIRI
Middle Name:C
Last Name:PERL
Suffix:
Gender:F
Credentials:LPN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 ROUTE 46 STE 230E
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-2352
Mailing Address - Country:US
Mailing Address - Phone:973-952-6455
Mailing Address - Fax:
Practice Address - Street 1:322 ROUTE 46 STE 230E
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-2352
Practice Address - Country:US
Practice Address - Phone:973-952-6455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-18
Last Update Date:2023-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP07042500164W00000X
NJL-302692174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No164W00000XNursing Service ProvidersLicensed Practical Nurse