Provider Demographics
NPI:1447285143
Name:PEARLSTONE, MELISSA M (MD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:M
Last Name:PEARLSTONE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:60 WESTWOOD AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708
Mailing Address - Country:US
Mailing Address - Phone:203-574-5501
Mailing Address - Fax:203-596-0912
Practice Address - Street 1:60 WESTWOOD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2460
Practice Address - Country:US
Practice Address - Phone:203-574-5501
Practice Address - Fax:203-596-0912
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT044221207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001442219Medicaid