Healthcare Provider Details

I. General information

NPI: 1720353725
Provider Name (Legal Business Name): ANTHONY RAY PERKINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2012
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 W 58TH ST FL 11
NEW YORK NY
10019-2515
US

IV. Provider business mailing address

4 W 58TH ST FL 11
NEW YORK NY
10019-2515
US

V. Phone/Fax

Practice location:
  • Phone: 212-355-7980
  • Fax:
Mailing address:
  • Phone: 212-355-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number2020-008430
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number271441
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number25MA09061000
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD441437
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: