| Staltaro Psychological Services Llc | |
|
2 Church St Rocky Hill CT 06067-1518 | |
| (860) 502-4908 | |
| (860) 513-4828 |
| Full Name | Staltaro Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2 Church St, Rocky Hill, Connecticut |
| Authorized Official Name and Position | Perry A Staltaro (PRESIDENT) |
| Authorized Official Contact | 8605024908 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Staltaro Psychological Services Llc 2 Church St Rocky Hill CT 06067-1518 Ph: (860) 502-4908 | Staltaro Psychological Services Llc 2 Church St Rocky Hill CT 06067-1518 Ph: (860) 502-4908 |
| NPI Number | 1841522216 |
|---|---|
| Provider Enumeration Date | 02/09/2010 |
| Last Update Date | 06/30/2024 |
| Certification Date | 06/30/2024 |
| Medicare PECOS PAC ID | 8729117155 |
|---|---|
| Medicare Enrollment ID | O20100524000743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841522216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Perry Anthony Staltaro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811982655 PECOS PAC ID: 1557330271 Enrollment ID: I20100524000771 |
| Provider Name | Shirley Oribio Staltaro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275656266 PECOS PAC ID: 9931130044 Enrollment ID: I20120531000288 |
| Provider Name | Tracie Preli-derwin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497014344 PECOS PAC ID: 8426213000 Enrollment ID: I20120705000221 |
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