Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | PRO21473-1 | NY |
NPI | 1003033036 |
---|---|
Provider Name | Mr. Raymond Harry Perlman |
First Address | Plainview, NY 11803-5801 |
Second Address | Deer Park, NY 11729-4219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 08/07/2007 |