Provider Demographics
NPI:1154943058
Name:PERLYSKY, TOVA BATSHEVA (PA-C)
Entity type:Individual
Prefix:MS
First Name:TOVA
Middle Name:BATSHEVA
Last Name:PERLYSKY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2 LAKESIDE DR W
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1703
Mailing Address - Country:US
Mailing Address - Phone:516-528-5099
Mailing Address - Fax:
Practice Address - Street 1:2 LAKESIDE DR W
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1703
Practice Address - Country:US
Practice Address - Phone:516-528-5099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant