Provider Demographics
NPI:1770560500
Name:PERLMAN, ELLIOT M (MD)
Entity type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:M
Last Name:PERLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E MANNING ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5109
Mailing Address - Country:US
Mailing Address - Phone:401-272-2020
Mailing Address - Fax:401-421-5979
Practice Address - Street 1:150 E MANNING ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5109
Practice Address - Country:US
Practice Address - Phone:401-272-2020
Practice Address - Fax:401-421-5979
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD05526207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0032762OtherNEIGHBORHOOD MA
RI180036712OtherRAILROAD MEDICARE
RI9001520Medicaid
RIEP11768Medicaid
RI0800188OtherUNITED
RI5890185OtherAETNA
RI001754OtherBLUE CHIP
RI1290058OtherCIGNA
RI153562OtherHARVARD
RI1621OtherNEIGHBORHOOD RI
MA42363OtherBCBSRI MASS GROUP #
RIJ04972OtherMASS BLUE SHIELD
RI603940OtherTUFTS GROUP #
RI26587OtherRI BLUE SHIELD
RI718346OtherTUFTS
MA0032762OtherNEIGHBORHOOD MA
RI603940OtherTUFTS GROUP #
RI9001520Medicaid
RI007005637Medicare PIN