Provider Demographics
NPI:1548490865
Name:PERLMUTTER, ALEXIS WEYMANN (MD)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:WEYMANN
Last Name:PERLMUTTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 DELAWARE AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1402
Mailing Address - Country:US
Mailing Address - Phone:518-655-1990
Mailing Address - Fax:518-449-7210
Practice Address - Street 1:250 DELAWARE AVE STE 207
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1402
Practice Address - Country:US
Practice Address - Phone:518-655-1990
Practice Address - Fax:518-449-7210
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283370207N00000X, 207NP0225X
PAMD445591208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics