Provider Demographics
NPI:1881787950
Name:PERFATER, KRISTEN LEIGH (TECHNICIAN)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:LEIGH
Last Name:PERFATER
Suffix:
Gender:F
Credentials:TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 MOHEGAN AVE
Mailing Address - Street 2:USCGC EAGLE (WIX 327)
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-8110
Mailing Address - Country:US
Mailing Address - Phone:860-439-1562
Mailing Address - Fax:860-439-1659
Practice Address - Street 1:45 MOHEGAN AVE
Practice Address - Street 2:USCGC EAGLE (WIX 327)
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-8110
Practice Address - Country:US
Practice Address - Phone:860-439-1562
Practice Address - Fax:860-439-1659
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other