Provider Demographics
NPI:1013168475
Name:PERLSTEIN, EPHRAIM (MOHEL/RITUAL CIRCUMC)
Entity Type:Individual
Prefix:MR
First Name:EPHRAIM
Middle Name:
Last Name:PERLSTEIN
Suffix:
Gender:M
Credentials:MOHEL/RITUAL CIRCUMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:396 BEACH 12TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5528
Mailing Address - Country:US
Mailing Address - Phone:718-327-6543
Mailing Address - Fax:718-327-6543
Practice Address - Street 1:396 BEACH 12TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5528
Practice Address - Country:US
Practice Address - Phone:718-327-6543
Practice Address - Fax:718-327-6543
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist