Provider Demographics
NPI:1962491878
Name:PEARLSTONE, DAVID BRADSHAW (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRADSHAW
Last Name:PEARLSTONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 SPORT HILL RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612-2203
Mailing Address - Country:US
Mailing Address - Phone:203-913-0969
Mailing Address - Fax:
Practice Address - Street 1:166 SPORT HILL RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:CT
Practice Address - Zip Code:06612-2203
Practice Address - Country:US
Practice Address - Phone:203-913-0969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT44328208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT44328OtherCT LICENSE