| Dr Joseph P Pedoto Llc | |
|
605 Bloomfield Ave Suite 7 Montclair NJ 07042-2859 | |
| (973) 783-7772 | |
| Not Available |
| Full Name | Dr Joseph P Pedoto Llc |
|---|---|
| Speciality | Psychologist |
| Location | 605 Bloomfield Ave, Montclair, New Jersey |
| Authorized Official Name and Position | Joseph P Pedoto (CEO) |
| Authorized Official Contact | 9736504796 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Joseph P Pedoto Llc 30 Holland Cir Sparta NJ 07871-1928 Ph: (973) 650-4796 | Dr Joseph P Pedoto Llc 605 Bloomfield Ave Suite 7 Montclair NJ 07042-2859 Ph: (973) 783-7772 |
| NPI Number | 1992129159 |
|---|---|
| Provider Enumeration Date | 02/08/2014 |
| Last Update Date | 02/08/2014 |
| Medicare PECOS PAC ID | 3274763800 |
|---|---|
| Medicare Enrollment ID | O20140227001576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992129159 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 35S100299100 (New Jersey) | Primary |
| Provider Name | Joseph P Pedoto |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093868135 PECOS PAC ID: 9931145943 Enrollment ID: I20050629001211 |
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