Provider Demographics
NPI:1134575921
Name:PERNA, ADAM (LAC)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:PERNA
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:65 E NORTHFIELD RD STE L
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4525
Mailing Address - Country:US
Mailing Address - Phone:973-486-6177
Mailing Address - Fax:973-486-6186
Practice Address - Street 1:65 E NORTHFIELD RD STE L
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4525
Practice Address - Country:US
Practice Address - Phone:973-486-6177
Practice Address - Fax:973-486-6186
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-11
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY005048171100000X
NJ25MZ00107200171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist