Provider Demographics
NPI:1245650555
Name:PERCHEMLIDES, MATTHEW (FNP-C, ND, FABNO)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:PERCHEMLIDES
Suffix:
Gender:
Credentials:FNP-C, ND, FABNO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 LEDGE LN
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:VT
Mailing Address - Zip Code:05753-8580
Mailing Address - Country:US
Mailing Address - Phone:802-458-7645
Mailing Address - Fax:
Practice Address - Street 1:214 LEDGE LN
Practice Address - Street 2:
Practice Address - City:CORNWALL
Practice Address - State:VT
Practice Address - Zip Code:05753-8580
Practice Address - Country:US
Practice Address - Phone:802-458-7645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-25
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0063576175F00000X
VT101.0137726363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No175F00000XOther Service ProvidersNaturopath