Provider Demographics
NPI:1841280997
Name:PERPER, YAKOV (MD)
Entity type:Individual
Prefix:
First Name:YAKOV
Middle Name:
Last Name:PERPER
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 1:50 VALLEY LN W
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-3633
Mailing Address - Country:US
Mailing Address - Phone:516-792-5849
Mailing Address - Fax:516-792-5849
Practice Address - Street 1:25-03 27TH STREET
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102
Practice Address - Country:US
Practice Address - Phone:718-687-2010
Practice Address - Fax:718-517-2410
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224072208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH61192Medicare UPIN