Basic Information
Provider Information
NPI: 1669471470
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PERL
FirstName: DANIEL
MiddleName: PETER
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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Mailing Information
Address1: 1 GUSTAVE L LEVY PL
Address2: PATHOLOGY, BOX 1194
City: NEW YORK
State: NY
PostalCode: 100296500
CountryCode: US
TelephoneNumber: 2122419117
FaxNumber: 2129961343
Practice Location
Address1: 1 GUSTAVE L LEVY PL
Address2: PATHOLOGY, BOX 1194
City: NEW YORK
State: NY
PostalCode: 100296500
CountryCode: US
TelephoneNumber: 2127317771
FaxNumber: 2125347491
Other Information
ProviderEnumerationDate: 07/14/2005
LastUpdateDate: 04/26/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZN0500X104834NYY Allopathic & Osteopathic PhysiciansPathologyNeuropathology
207ZP0101X104834NYN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology

No ID Information.


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