Provider Demographics
NPI:1841294220
Name:PERILSTEIN, PHILIP STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:STEVEN
Last Name:PERILSTEIN
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 1:225 NEWTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-5221
Mailing Address - Country:US
Mailing Address - Phone:215-441-6650
Mailing Address - Fax:215-441-6830
Practice Address - Street 1:225 NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:WARMISNTER
Practice Address - State:PA
Practice Address - Zip Code:18974
Practice Address - Country:US
Practice Address - Phone:215-441-6650
Practice Address - Fax:215-441-6830
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07952000207Q00000X
PAMD422271207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0090328Medicaid
PA101098442Medicaid
NJ0090328Medicaid
NJ092589R63Medicare PIN
NJ092589YBAWMedicare PIN