Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 72280 | MA |
N | 111NI0900X | Internist | 72280 | MA |
Y | 207RG0300X | Geriatric Medicine | 72280 | MA |
NPI | 1093792939 |
---|---|
Provider Name | Thomas T. Perls |
First Address | Boston, MA 02118 |
Second Address | Boston, MA 02118-4001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2005 |
Last Update Date | 18/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110049180A | (05) | MA |
E65985 | (02) | MA |