Provider Demographics
NPI:1780912907
Name:MOLINOFF, PERRY BROWN (MD)
Entity type:Individual
Prefix:DR
First Name:PERRY
Middle Name:BROWN
Last Name:MOLINOFF
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 1:3620 HAMILTON WALK
Mailing Address - Street 2:204 ANATOMY CHEMISTRY BUILDING
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4799
Mailing Address - Country:US
Mailing Address - Phone:215-898-2832
Mailing Address - Fax:
Practice Address - Street 1:3620 HAMILTON WALK
Practice Address - Street 2:204 ANATOMY CHEMISTRY BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4799
Practice Address - Country:US
Practice Address - Phone:215-898-2832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-29
Last Update Date:2009-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041400L174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator