Provider Demographics
NPI:1538343363
Name:ALEC PERLSON OD
Entity type:Organization
Organization Name:ALEC PERLSON OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:O.D.
Authorized Official - Prefix:
Authorized Official - First Name:ALEC
Authorized Official - Middle Name:
Authorized Official - Last Name:PERLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-238-3030
Mailing Address - Street 1:26 S GREELEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3332
Mailing Address - Country:US
Mailing Address - Phone:914-238-3030
Mailing Address - Fax:
Practice Address - Street 1:26 S GREELEY AVE
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-3332
Practice Address - Country:US
Practice Address - Phone:914-238-3030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV003123-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0658640001Medicare NSC