Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N003480 | NY |
NPI | 1154378537 |
---|---|
Provider Name | Dr. Joseph Thomas Perillo |
First Address | Geneva, NY 14456-1334 |
Second Address | Geneva, NY 14456-1334 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 10/12/2007 |