=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518696897
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REBECCA KAB-PERLMAN MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/10/2022
-----------------------------------------------------
Last Update Date | 10/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 445 OAK ST FL 2
-----------------------------------------------------
City | COPIAGUE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11726-3111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 844-400-1975
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 710 PROSPECT PL
-----------------------------------------------------
City | BELLMORE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11710-4520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 929-422-8935
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 340263
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------