Healthcare Provider Details

I. General information

NPI: 1235312521
Provider Name (Legal Business Name): DR MICHAEL PERLSTEIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4414 14TH AVE
BROOKLYN NY
11219-2104
US

IV. Provider business mailing address

4414 14TH AVE
BROOKLYN NY
11219-2104
US

V. Phone/Fax

Practice location:
  • Phone: 718-438-8188
  • Fax: 718-853-0169
Mailing address:
  • Phone: 718-438-8188
  • Fax: 718-853-0169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberN004124
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberN004124
License Number StateNY

VIII. Authorized Official

Name: DR. MICHAEL PERLSTEIN
Title or Position: OWNER
Credential: DPM
Phone: 718-438-8188