Provider Demographics
NPI: | 1285644948 |
---|---|
Name: | PERLMAN, BARRY J (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | BARRY |
Middle Name: | J |
Last Name: | PERLMAN |
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: | 3674 ROUTE 27, PRINCETON RADIOLOGY ASSOCIATES, P.A. |
Mailing Address - Street 2: | DEPARTMENT B |
Mailing Address - City: | KENDALL PARK |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 08824 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 732-821-5563 |
Mailing Address - Fax: | 732-821-6675 |
Practice Address - Street 1: | 3674 ROUTE 27, PRINCETON RADIOLOGY ASSOCIATES, P.A. |
Practice Address - Street 2: | DEPARTMENT B |
Practice Address - City: | KENDALL PARK |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08824 |
Practice Address - Country: | US |
Practice Address - Phone: | 732-821-5563 |
Practice Address - Fax: | 732-821-6675 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-08-08 |
Last Update Date: | 2007-08-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NJ | 25MA67314 | 2085R0202X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NJ | 7879806 | Medicaid | |
NJ | 017625 | Medicare ID - Type Unspecified | |
NJ | G79519 | Medicare UPIN |