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NPI Code Detail

MEDICARE: DR. IRA HAYM PEARLMAN PH.D.

MEDICARE: DR. IRA HAYM PEARLMAN PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist0810000975VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1018993OTHERVAVALUE OPTIONS
2080016OTHERVASENTARA BEH. HEALTH
3066475OTHERVAANTHEM BC/BS

General Provider Information

NPI Number : 1447253695
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IRA HAYM PEARLMAN PH.D.
Provider Business Mailing Address
First Line : 1709 COLLEY AVE
Second Line : STE 202
City : NORFOLK
State : VA
Zip : 23517-1675
Country : US
Telephone Number : 757-625-5623
Fax Number : 757-627-1557
Provider Business Practice Location Address
First Line : 1709 COLLEY AVE
Second Line : STE 202
City : NORFOLK
State : VA
Zip : 23517-1675
Country : US
Telephone Number : 757-625-5623
Fax Number : 757-627-1557
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 07/08/2007

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