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General NPI Number Information
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NPI Number | 1578040952
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Entity Type | Individual
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Provider Name | KERRY R PITTER PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2018
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 221 RIVER STREET, 9TH FLOOR
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City | HOBOKEN
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State | NJ
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Zip | 07030
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Country | US
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Telephone | 551-204-2930
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Fax |
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Provider Business Mailing Address
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Address Line | 221 RIVER STREET, 9TH FLOOR
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City | HOBOKEN
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State | NJ
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Zip | 07030
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Country | US
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Telephone | 551-204-2930
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 12045217
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 35S100589500
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License Number State | NJ
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