Michael James Perlotto, PSY.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

016211 Issued in NY

Practice address

646 Main St
Port Jefferson, NY 11777-2235

Phone

(631) 689-1462

NPI assigned

Jan 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285784686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900430",
            "telephone_number": "631-689-1462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772235",
            "telephone_number": "631-689-1462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERLOTTO",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "016211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROVIDER #",
            "identifier": "0110537",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Pereira, MD
• Lisa Pereira, AGNP-C
• Heather Perez, LMT
• Gabriella Perinuzzi
• John Michael Perlman, DDS
• Ralph Perricelli
• Priscilla Persaud, M.D.
• Christina Pestieau, MS
• Kerrin Peterson
• John Gregg Petraco, MD

• Clinical Child & Adolescent Psychologist in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Clinical Child & Adolescent Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.