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General NPI Number Information
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NPI Number | 1467849786
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Entity Type | Organization
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Legal Business Name | BETH CERRITO PHD PSYCHOLOGIST PC
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Dates
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Enumeration Date | 04/24/2015
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Last Update Date | 04/24/2015
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Provider Practice Location Address
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Address Line | 1357 MONROE AVE
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City | ROCHESTER
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State | NY
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Zip | 14618-1005
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Country | US
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Telephone | 585-442-9601
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Fax | 585-442-9606
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Provider Business Mailing Address
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Address Line | 1357 MONROE AVE
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City | ROCHESTER
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State | NY
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Zip | 14618-1005
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Country | US
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Telephone | 585-442-9601
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Fax | 585-442-9606
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Authorized Official
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Title or Position | PRESIDENT
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Name | BETH CERRITO
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Credential | PHD
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Telephone | 585-737-7447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 018331
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License Number State | NY
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