Provider Demographics
NPI:1295779395
Name:PEARLMAN, RYAN D (DC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:D
Last Name:PEARLMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5781 BRIDGE STREET, SUITE 34
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057
Mailing Address - Country:US
Mailing Address - Phone:315-314-7761
Mailing Address - Fax:315-299-4723
Practice Address - Street 1:5781 BRIDGE ST STE 34
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-2944
Practice Address - Country:US
Practice Address - Phone:315-314-7761
Practice Address - Fax:315-299-4723
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010783111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU98962Medicare UPIN
NYIA1005Medicare PIN