Provider Demographics
NPI:1972505238
Name:PERLSTEIN, MICHAEL (DPM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:PERLSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4414 14 AVENUE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2104
Mailing Address - Country:US
Mailing Address - Phone:718-438-8188
Mailing Address - Fax:718-853-0169
Practice Address - Street 1:4414 14 AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2104
Practice Address - Country:US
Practice Address - Phone:718-438-8188
Practice Address - Fax:718-853-0169
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004124213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY103690101OtherHEALTHPLUS
NY00966981Medicaid
NY4471906-003OtherCIGNA
NYKS499OtherOXFORD
NY237111OtherUNITEDHEALTHCARE
NY112820045OtherMAGNACARE
NY1499695OtherGROUP HEALTH INCORPORATED
NY4471906-003OtherCIGNA
NYT51336Medicare UPIN