Provider Demographics
NPI:1649261728
Name:PERKINS, ELIZABETH ROGERS (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ROGERS
Last Name:PERKINS
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 1:345 WOODCLIFF DR STE 1A
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-4210
Mailing Address - Country:US
Mailing Address - Phone:212-772-3111
Mailing Address - Fax:
Practice Address - Street 1:61 E 77TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1817
Practice Address - Country:US
Practice Address - Phone:212-772-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-29
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME794262085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL49367ZMedicare ID - Type Unspecified
FL49637OtherBLUECROSS/BLUESHIELD
FL258235000Medicaid
FL300108682OtherRAILROAD MEDICARE
FLH11119Medicare UPIN