Provider Demographics
NPI:1376647578
Name:RICHARD A PEARL MD PC
Entity type:Organization
Organization Name:RICHARD A PEARL MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEARL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-265-4485
Mailing Address - Street 1:45 TERRY ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787
Mailing Address - Country:US
Mailing Address - Phone:631-265-4485
Mailing Address - Fax:631-265-3620
Practice Address - Street 1:45 TERRY ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787
Practice Address - Country:US
Practice Address - Phone:631-265-4485
Practice Address - Fax:631-265-3620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty