Basic Information
Provider Information
NPI: 1407939002
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PERLSTEIN
FirstName: CLAIRE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MHS, PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1320 GILEAD RD
Address2:  
City: MT PLEASANT
State: SC
PostalCode: 294668522
CountryCode: US
TelephoneNumber: 8438495932
FaxNumber:  
Practice Location
Address1: 306 STATION 22 1/2 ST
Address2:  
City: SULLIVANS ISLAND
State: SC
PostalCode: 294829756
CountryCode: US
TelephoneNumber: 8438830054
FaxNumber: 8438830064
Other Information
ProviderEnumerationDate: 10/24/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2251X0800X3914SCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic

No ID Information.


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