Provider Demographics
NPI:1144360504
Name:PERLINE CHIROPRACTIC, PC
Entity type:Organization
Organization Name:PERLINE CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:BROOK
Authorized Official - Last Name:PERLINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:212-371-0700
Mailing Address - Street 1:920 3RD AVE
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3627
Mailing Address - Country:US
Mailing Address - Phone:212-371-0700
Mailing Address - Fax:212-750-9114
Practice Address - Street 1:920 3RD AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3627
Practice Address - Country:US
Practice Address - Phone:212-371-0700
Practice Address - Fax:212-750-9114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0100851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX6V56OtherEMPIRE BC BS
NYU89151Medicare UPIN
NYX6V56OtherEMPIRE BC BS