Provider Demographics
NPI: | 1124098751 |
---|---|
Name: | PEARLMAN, JOSHUA (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | JOSHUA |
Middle Name: | |
Last Name: | PEARLMAN |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 68 S SERVICE RD |
Mailing Address - Street 2: | SUITE 350Q |
Mailing Address - City: | MELVILLE |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11747-2354 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 516-945-3000 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 270 PARK AVE |
Practice Address - Street 2: | |
Practice Address - City: | HUNTINGTON |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11743-2787 |
Practice Address - Country: | US |
Practice Address - Phone: | 631-351-2785 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-01-25 |
Last Update Date: | 2009-11-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 238306 | 207L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 02755833 | Medicaid | |
NY | CB1521 | Other | RAILROAD MEDICARE GROUP |
NY | P00337233 | Other | RAILROAD MEDICARE |
NY | CB1521 | Other | RAILROAD MEDICARE GROUP |
NY | P00337233 | Other | RAILROAD MEDICARE |
NY | 1280T1 | Medicare ID - Type Unspecified |