Provider Demographics
NPI:1851458111
Name:PERFILIO, ALLAN F (DC)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:F
Last Name:PERFILIO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 MORGAN HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411
Mailing Address - Country:US
Mailing Address - Phone:570-586-7778
Mailing Address - Fax:570-587-4276
Practice Address - Street 1:614 MORGAN HIGHWAY
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411
Practice Address - Country:US
Practice Address - Phone:570-586-7778
Practice Address - Fax:570-587-4276
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003321L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011146410002Medicaid
425319Medicare ID - Type Unspecified
T30350Medicare UPIN