Healthcare Provider Details

I. General information

NPI: 1548940075
Provider Name (Legal Business Name): TAYLOR PERLMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 3RD AVE APT 626
MINEOLA NY
11501-4343
US

IV. Provider business mailing address

1 3RD AVE APT 626
MINEOLA NY
11501-4343
US

V. Phone/Fax

Practice location:
  • Phone: 516-554-1166
  • Fax:
Mailing address:
  • Phone: 516-554-1166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number027331
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: