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General NPI Number Information
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NPI Number | 1952635484
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Entity Type | Individual
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Provider Name | NAOMI C. PEARL M.S.E.
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Gender | Female
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Dates
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Enumeration Date | 10/01/2009
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Last Update Date | 10/01/2009
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Provider Practice Location Address
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Address Line | 7238 MAIN ST
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City | FLUSHING
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State | NY
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Zip | 11367-2408
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Country | US
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Telephone | 718-972-0880
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Fax | 718-997-7029
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Provider Business Mailing Address
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Address Line | 14119 71ST RD
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City | FLUSHING
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State | NY
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Zip | 11367-1944
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Country | US
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Telephone | 718-544-6442
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1853654
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License Number State | NY
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