Provider Demographics
NPI:1427760198
Name:DECAUL, PERLINA CLAUDETTE
Entity type:Individual
Prefix:MS
First Name:PERLINA
Middle Name:CLAUDETTE
Last Name:DECAUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5735 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-4857
Mailing Address - Country:US
Mailing Address - Phone:718-495-1961
Mailing Address - Fax:718-701-8325
Practice Address - Street 1:5735 KINGS HWY APT 1A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-4827
Practice Address - Country:US
Practice Address - Phone:718-495-1961
Practice Address - Fax:718-701-8325
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223193164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse