Healthcare Provider Details

I. General information

NPI: 1679804066
Provider Name (Legal Business Name): PETER SAETTA L.C.S.W
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2010
Last Update Date: 01/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 PALISADE AVE
YONKERS NY
10701-8315
US

IV. Provider business mailing address

10 PALISADE AVE
YONKERS NY
10701-8315
US

V. Phone/Fax

Practice location:
  • Phone: 914-423-4466
  • Fax: 914-423-4346
Mailing address:
  • Phone: 914-423-4466
  • Fax: 914-423-4346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number072626-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: