Basic Information
| Provider Information | |||||||||
| NPI: | 1275790842 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PERK | ||||||||
| FirstName: | JONATHAN | ||||||||
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| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 241 E 76TH ST | ||||||||
| Address2: | APT 3F | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100212164 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127949691 | ||||||||
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| Practice Location | |||||||||
| Address1: | 339 HICKS ST | ||||||||
| Address2: | LICH, NEUROLOGY DEPARTMENT | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112015509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187801124 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2008 | ||||||||
| LastUpdateDate: | 11/26/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 204D00000X | 259413 | NY | Y | Allopathic & Osteopathic Physicians | Neuromusculoskeletal Medicine & OMM |
No ID Information.