Provider Demographics
NPI: | 1952653529 |
---|---|
Name: | DR PEARLMAN S MEDICAL CARE P.C. |
Entity Type: | Organization |
Organization Name: | DR PEARLMAN S MEDICAL CARE P.C. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | GARY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PEARLMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 718-331-3939 |
Mailing Address - Street 1: | 8214 18TH AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | BROOKLYN |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11214-2901 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 718-331-3939 |
Mailing Address - Fax: | 718-331-4321 |
Practice Address - Street 1: | 8214 18TH AVE |
Practice Address - Street 2: | |
Practice Address - City: | BROOKLYN |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11214 |
Practice Address - Country: | US |
Practice Address - Phone: | 718-331-3939 |
Practice Address - Fax: | 718-331-4321 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-10-08 |
Last Update Date: | 2012-10-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 155908 | 208000000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Single Specialty |