Provider Demographics
NPI:1750928156
Name:PERL, RAIZEL
Entity type:Individual
Prefix:
First Name:RAIZEL
Middle Name:
Last Name:PERL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RAIZEL
Other - Middle Name:
Other - Last Name:SCHECHTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:142 COLUMBIA BLVD
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06710-1704
Mailing Address - Country:US
Mailing Address - Phone:845-213-5620
Mailing Address - Fax:
Practice Address - Street 1:142 COLUMBIA BLVD
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06710-1704
Practice Address - Country:US
Practice Address - Phone:845-213-5620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5308225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist