Provider Demographics
NPI:1952853756
Name:DR. ALEC PERLSON, OPTOMETRIST
Entity Type:Organization
Organization Name:DR. ALEC PERLSON, OPTOMETRIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEC
Authorized Official - Middle Name:
Authorized Official - Last Name:PERLSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:914-238-3030
Mailing Address - Street 1:26 S GREELEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3332
Mailing Address - Country:US
Mailing Address - Phone:914-238-3030
Mailing Address - Fax:914-238-5757
Practice Address - Street 1:26 S GREELEY AVE
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-3332
Practice Address - Country:US
Practice Address - Phone:914-238-3030
Practice Address - Fax:914-238-5757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT003123-1261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care