Provider Demographics
NPI:1811093552
Name:PERNA, FRANK (PHD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:PERNA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 E NEWTON ST
Mailing Address - Street 2:M620
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2340
Mailing Address - Country:US
Mailing Address - Phone:617-414-2030
Mailing Address - Fax:617-414-1937
Practice Address - Street 1:85 E NEWTON ST
Practice Address - Street 2:M620
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2340
Practice Address - Country:US
Practice Address - Phone:617-414-2030
Practice Address - Fax:617-414-1937
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPY7670PR103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist