Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 259413 | NY |
NPI | 1275790842 |
---|---|
Provider Name | Dr. Jonathan Perk |
First Address | New York, NY 10021-2164 |
Second Address | Brooklyn, NY 11201-5509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 26/11/2012 |