Provider Demographics
NPI:1235405127
Name:PERNELL, CHRIS TONYA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:TONYA
Last Name:PERNELL
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 BERKELEY AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07104-1436
Mailing Address - Country:US
Mailing Address - Phone:973-975-7663
Mailing Address - Fax:
Practice Address - Street 1:80 BERKELEY AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-1436
Practice Address - Country:US
Practice Address - Phone:973-975-7663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program