Healthcare Provider Details

I. General information

NPI: 1992150510
Provider Name (Legal Business Name): AMY MARIA LETTERI PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2016
Last Update Date: 06/07/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 PENN AVE LAWRENCEVILLE MEDICAL BUILDING, 3RD FLOOR
PITTSBURGH PA
15224
US

IV. Provider business mailing address

4401 PENN AVE
PITTSBURGH PA
15224-1342
US

V. Phone/Fax

Practice location:
  • Phone: 412-962-5325
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS018625
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS018625
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: