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General NPI Number Information
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NPI Number | 1609916261
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Entity Type | Individual
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Provider Name | SUSAN MARIA LOTTO PH. D, CASAC
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 971 JEROME ST
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City | BROOKLYN
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State | NY
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Zip | 11207-9252
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Country | US
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Telephone | 718-272-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 751 E 102ND ST
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City | BROOKLYN
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State | NY
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Zip | 11236-2607
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Country | US
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Telephone | 718-272-9529
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 012572-1
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License Number State | NY
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