Provider Demographics
NPI:1750722112
Name:PERRI CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:PERRI CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PERRI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-928-2225
Mailing Address - Street 1:489 STATE ROUTE 32
Mailing Address - Street 2:PO BOX 1012
Mailing Address - City:HIGHLAND MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10930-3305
Mailing Address - Country:US
Mailing Address - Phone:845-928-2225
Mailing Address - Fax:845-928-1080
Practice Address - Street 1:489 STATE ROUTE 32
Practice Address - Street 2:
Practice Address - City:HIGHLAND MILLS
Practice Address - State:NY
Practice Address - Zip Code:10930-3305
Practice Address - Country:US
Practice Address - Phone:845-928-2225
Practice Address - Fax:845-928-1080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011412-1111N00000X
NYX004177-1111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1184603375OtherINDIVIDUAL NPI
NY1932440377OtherINDIVIDUAL NPI