Provider Demographics
NPI:1184849549
Name:VAINER, JUANA L (MD)
Entity type:Individual
Prefix:
First Name:JUANA
Middle Name:L
Last Name:VAINER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 PICKMAN DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1005
Mailing Address - Country:US
Mailing Address - Phone:781-581-4461
Mailing Address - Fax:
Practice Address - Street 1:TRI CITY MENTAL HEALTH CTR
Practice Address - Street 2:95 PLEASANT STREET
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901
Practice Address - Country:US
Practice Address - Phone:781-581-4461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1536472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry