Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 235700 | NY |
N | 207K00000X | Allergist & Immunologist | 235910 | MA |
N | 208000000X | Pediatrician | 235700 | NY |
N | 208000000X | Pediatrician | 235910 | MA |
Y | 2080P0201X | Pediatric Allergist | 235700 | NY |
NPI | 1518127265 |
---|---|
Provider Name | Dr. Perdita Permaul |
First Address | New York, NY 10021-5320 |
Second Address | Boston, MA 02114-3108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 15/05/2020 |