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NPI Code Detail

MEDICARE: KAITLIN CARROZZA PSY.D.

MEDICARE:   KAITLIN  CARROZZA  PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist020172NY

General Provider Information

NPI Number : 1346682960
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLIN CARROZZA PSY.D.
Provider Business Mailing Address
First Line : 1513 SOUTH AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-2926
Country : US
Telephone Number : 585-270-1463
Fax Number :
Provider Business Practice Location Address
First Line : 1513 SOUTH AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-2926
Country : US
Telephone Number : 585-270-1463
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2013
Last Update Date : 07/24/2013

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Directions to “ KAITLIN CARROZZA PSY.D.” Practice Location

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