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General NPI Number Information
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NPI Number | 1588806863
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Entity Type | Organization
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Legal Business Name | PERRY PHYSICAL MEDICINE & REHABILITATION, P.C.
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 04/01/2009
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Provider Practice Location Address
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Address Line | 2033 DEER PARK AVE
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City | DEER PARK
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State | NY
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Zip | 11729-2109
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Country | US
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Telephone | 631-586-3700
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Fax | 631-586-3735
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Provider Business Mailing Address
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Address Line | 2033 DEER PARK AVE
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City | DEER PARK
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State | NY
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Zip | 11729-2109
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Country | US
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Telephone | 631-586-3700
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Fax | 631-586-3735
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY PERRY
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Credential | D.O.
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Telephone | 631-586-3700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 204650
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License Number State | NY
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