Provider Demographics
NPI:1912932385
Name:PEARL, ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:PEARL
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 1:15 CORPORATE DR
Mailing Address - Street 2:STE 2-8
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611
Mailing Address - Country:US
Mailing Address - Phone:203-452-7081
Mailing Address - Fax:203-452-7089
Practice Address - Street 1:15 CORPORATE DR
Practice Address - Street 2:STE 2-8
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611
Practice Address - Country:US
Practice Address - Phone:203-452-7081
Practice Address - Fax:203-452-7089
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT040444207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
010040444CT01OtherBLUE CROSS
1291146003OtherCIGNA
P2625945OtherOXFORD
2846297OtherAETNA
061491182OtherUHC
2V1530OtherHEALTHNET
404440OtherCONNECTICARE
P2625945OtherOXFORD
2846297OtherAETNA