| Peter Tolisano Psyd Llc | |
|
68 S Main St Suite 100 West Hartford CT 06107-2445 | |
| (860) 778-4942 | |
| Not Available |
| Full Name | Peter Tolisano Psyd Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 68 S Main St, West Hartford, Connecticut |
| Authorized Official Name and Position | Peter Paul Tolisano (OWNER) |
| Authorized Official Contact | 8607784942 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter Tolisano Psyd Llc 111 Dekoven Dr #1201 Middletown CT 06457-3403 Ph: (860) 778-4942 | Peter Tolisano Psyd Llc 68 S Main St Suite 100 West Hartford CT 06107-2445 Ph: (860) 778-4942 |
| NPI Number | 1811379662 |
|---|---|
| Provider Enumeration Date | 06/28/2015 |
| Last Update Date | 06/28/2015 |
| Medicare PECOS PAC ID | 4789943010 |
|---|---|
| Medicare Enrollment ID | O20180112001606 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811379662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2993 (Connecticut) | Primary |
| Provider Name | Peter P Tolisano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356568851 PECOS PAC ID: 0345381364 Enrollment ID: I20100112000595 |
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