MEDICARE: ADRIAN J HERNANDEZ PHD, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY10001878	MA

General Provider Information

NPI Number	:	1013503291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIAN J HERNANDEZ PHD, LP

Provider Business Mailing Address
First Line	:	151 EVERETT AVE
Second Line	:
City	:	CHELSEA
State	:	MA
Zip	:	02150-1812
Country	:	US
Telephone Number	:	617-884-8300
Fax Number	:	617-889-8509

Provider Business Practice Location Address
First Line	:	151 EVERETT AVE
Second Line	:
City	:	CHELSEA
State	:	MA
Zip	:	02150-1812
Country	:	US
Telephone Number	:	617-884-8300
Fax Number	:	617-889-8509

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2020
Last Update Date	:	01/16/2026

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