Provider Demographics
NPI:1205847399
Name:PERLMUTTER, BARBARA LEE (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:LEE
Last Name:PERLMUTTER
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 SHEARWATER CT W
Mailing Address - Street 2:UNIT 34
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-5418
Mailing Address - Country:US
Mailing Address - Phone:201-963-5886
Mailing Address - Fax:201-432-3608
Practice Address - Street 1:330 GRAND ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-2728
Practice Address - Country:US
Practice Address - Phone:201-963-5886
Practice Address - Fax:201-432-3608
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03352200207R00000X
NY131164207R00000X
ME008974207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01471241Medicaid
NY12193OtherSTATE DISABILITY ID NO.
NY21A94OtherBLUE CROSS/BLUE SHIELD NO
222261204OtherFEDERAL TAX ID NO.
03305760781OtherMEDICAL EDUCATION NO.
NY2595791OtherPROVIDER ID NO.
NJPE482561Medicare ID - Type Unspecified
NY21A94OtherBLUE CROSS/BLUE SHIELD NO
NY21A94Medicare ID - Type Unspecified