Healthcare Provider Details

I. General information

NPI: 1619914819
Provider Name (Legal Business Name): MARSHAL D PERIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 ROUTE 312
BREWSTER NY
10509-2337
US

IV. Provider business mailing address

110 S BEDFORD RD CARE MOUNT MEDICAL, PC
MOUNT KISCO NY
10549-3446
US

V. Phone/Fax

Practice location:
  • Phone: 845-278-7000
  • Fax: 845-278-4968
Mailing address:
  • Phone: 914-241-1050
  • Fax: 914-242-5685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number224327
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: