Provider Demographics
NPI:1053902429
Name:PERLMAN, JANE L (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:L
Last Name:PERLMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 CARUSO CT
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-6608
Mailing Address - Country:US
Mailing Address - Phone:678-361-8057
Mailing Address - Fax:
Practice Address - Street 1:4317 CHAMBLEE TUCKER RD
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-2106
Practice Address - Country:US
Practice Address - Phone:770-938-6146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19918183500000X
GARPH020633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist