Perry D Nisen, M.D., PH.D.

Primary specialty

Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X

License

MD427562 Issued in PA

Practice address

1250 S Collegeville Rd
Up1455
Collegeville, PA 19426-2990

Phone

(610) 917-6754

Fax

(610) 917-4181

NPI assigned

Nov 9, 2009

Last updated

Nov 9, 2009By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1508193897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 S COLLEGEVILLE RD",
            "address_2": "UP1455",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194262990",
            "telephone_number": "610-917-6754",
            "fax_number": "610-917-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S COLLEGEVILLE RD",
            "address_2": "UP1455",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194262990",
            "telephone_number": "610-917-6754",
            "fax_number": "610-917-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISEN",
        "first_name": "PERRY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-09",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "PA",
            "license": "MD427562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Hematology & Oncology Physician in Collegeville, PA
• Providers in Collegeville, PA by specialty
• Pediatric Hematology & Oncology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; 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.