Provider Demographics
NPI:1871739763
Name:JULIE PERLANSKI MD
Entity type:Organization
Organization Name:JULIE PERLANSKI MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERLANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-823-1111
Mailing Address - Street 1:500 EAST MAIN SREET
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13365
Mailing Address - Country:US
Mailing Address - Phone:315-823-1111
Mailing Address - Fax:315-823-1295
Practice Address - Street 1:500 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NY
Practice Address - Zip Code:13365-1444
Practice Address - Country:US
Practice Address - Phone:315-823-1111
Practice Address - Fax:315-823-1295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203516207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01728514Medicaid
NYG35401Medicare UPIN
NYBA0618Medicare PIN
NY01728514Medicaid