Provider Demographics
NPI:1023360401
Name:IADAROLA, SUZANNAH JOY (PHD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:SUZANNAH
Middle Name:JOY
Last Name:IADAROLA
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 635
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-7787
Mailing Address - Fax:585-275-3366
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 671
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-2986
Practice Address - Fax:585-275-3366
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY19833103TC0700X
PA1-11-9692103K00000X
NY019833103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst