1457422735 NPI number — STEFANIE PERLE AUD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457422735 NPI number — STEFANIE PERLE AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PERLE
Provider First Name:
STEFANIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
AUD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457422735
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/17/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
224 TAYLORS MILLS RD
Provider Second Line Business Mailing Address:
SUITE #105B
Provider Business Mailing Address City Name:
MANALAPAN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07726-3281
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-462-8412
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
224 TAYLORS MILLS RD
Provider Second Line Business Practice Location Address:
SUITE 105B
Provider Business Practice Location Address City Name:
MANALAPAN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07726-3281
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-303-9660
Provider Business Practice Location Address Fax Number:
732-303-1810
Provider Enumeration Date:
11/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  YA000601 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237600000X , with the licence number: MG000984 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: YA000601 . This is a "AUDIOLOGIST" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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