Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 000463 | CT |
Y | 2081P2900X | Pain Medicine | 204650 | NY |
NPI | 1346248689 |
---|---|
Provider Name | Dr. Jeffrey Perry |
First Address | New York, NY 10016-2772 |
Second Address | New York, NY 10016-2772 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2005 |
Last Update Date | 17/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01828573 | (05) | NY |
G38654 | (02) |