Provider Demographics
NPI:1639293400
Name:PERKOSKI, TAMMY (PSYD)
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:
Last Name:PERKOSKI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FAWN LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-3236
Mailing Address - Country:US
Mailing Address - Phone:617-549-9459
Mailing Address - Fax:508-530-4163
Practice Address - Street 1:34 SCHOOL ST
Practice Address - Street 2:STE 200
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2318
Practice Address - Country:US
Practice Address - Phone:617-549-9459
Practice Address - Fax:508-530-4163
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9015103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP2286OtherMEDICARE