Provider Demographics
NPI:1194735951
Name:PEARLMAN, BARRY SAMUEL (DDS)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:SAMUEL
Last Name:PEARLMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 AVENUE M
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5273
Mailing Address - Country:US
Mailing Address - Phone:718-998-1536
Mailing Address - Fax:
Practice Address - Street 1:1507 AVENUE M
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5273
Practice Address - Country:US
Practice Address - Phone:718-998-1536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0360671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice