Basic Information
| Provider Information | |||||||||
| NPI: | 1952853756 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DR. ALEC PERLSON, OPTOMETRIST | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 26 S GREELEY AVE | ||||||||
| Address2: | |||||||||
| City: | CHAPPAQUA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105143332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142383030 | ||||||||
| FaxNumber: | 9142385757 | ||||||||
| Practice Location | |||||||||
| Address1: | 26 S GREELEY AVE | ||||||||
| Address2: | |||||||||
| City: | CHAPPAQUA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105143332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142383030 | ||||||||
| FaxNumber: | 9142385757 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2016 | ||||||||
| LastUpdateDate: | 10/27/2016 | ||||||||
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| AuthorizedOfficialLastName: | PERLSON | ||||||||
| AuthorizedOfficialFirstName: | ALEC | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9142383030 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | OD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | VUT003123-1 | NY | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.