Healthcare Provider Details
I. General information
NPI: 1811024110
Provider Name (Legal Business Name): NICHOLAS P. ARMENTI LICPSY
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 TER HEUN DR
FALMOUTH MA
02540-2525
US
IV. Provider business mailing address
PO BOX 1311
EAST ORLEANS MA
02643-1311
US
V. Phone/Fax
- Phone: 508-540-6550
- Fax: 508-540-7480
- Phone: 508-240-6506
- Fax: 508-240-6506
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 7962 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: