Individual provider Active NPI

Deborah Perlick, PH.D

  • Clinical Psychologist
  • Bronx, NY
National Provider Identifier
1124301361
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
006068 Issued in NY
Practice address
130 W Kingsbridge Rd
Room 6a-44
Bronx, NY 10468-3904
Phone
(914) 260-7453
NPI assigned
Sep 23, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 006068 NY Primary

Addresses

Primary practice location

130 W Kingsbridge Rd
Room 6a-44
Bronx, NY 10468-3904

Mailing address

130 W Kingsbridge Rd
Room 6a-44
Bronx, NY 10468-3904
Phone (914) 260-7453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
006068NYMDOphthalmology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1124301361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W KINGSBRIDGE RD",
            "address_2": "ROOM 6A-44",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104683904",
            "telephone_number": "914-260-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W KINGSBRIDGE RD",
            "address_2": "ROOM 6A-44",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104683904",
            "telephone_number": "914-260-7453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERLICK",
        "first_name": "DEBORAH",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-23",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "006068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.