Provider Demographics
NPI:1861608622
Name:PERPER, JEFFREY L (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:L
Last Name:PERPER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15337 78TH RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3541
Mailing Address - Country:US
Mailing Address - Phone:718-380-4047
Mailing Address - Fax:718-380-4048
Practice Address - Street 1:15337 78TH RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3541
Practice Address - Country:US
Practice Address - Phone:718-380-4047
Practice Address - Fax:718-380-4048
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004381-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor