Healthcare Provider Details

I. General information

NPI: 1346248689
Provider Name (Legal Business Name): JEFFREY PERRY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E 38TH ST
NEW YORK NY
10016-2772
US

IV. Provider business mailing address

333 E 38TH ST
NEW YORK NY
10016-2772
US

V. Phone/Fax

Practice location:
  • Phone: 212-598-6625
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number204650
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number000463
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: