Provider Demographics
NPI:1821017856
Name:DARYL PERLMAN PHYSICIAN PC
Entity Type:Organization
Organization Name:DARYL PERLMAN PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PERLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-470-1669
Mailing Address - Street 1:4230 HEMPSTEAD TPKE STE 106
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-5700
Mailing Address - Country:US
Mailing Address - Phone:516-470-1669
Mailing Address - Fax:516-470-1670
Practice Address - Street 1:4230 HEMPSTEAD TPKE STE 106
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5700
Practice Address - Country:US
Practice Address - Phone:516-470-1669
Practice Address - Fax:516-470-1670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226847207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY225ACEU691OtherPROVIDER TRANSACTION ACCESS NUMBER PTAN
NYWEU691OtherGROUP PTAN
NY225ACEU691OtherPROVIDER TRANSACTION ACCESS NUMBER PTAN