Provider Demographics
NPI:1053850107
Name:POSTORINO PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:POSTORINO PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LIA
Authorized Official - Middle Name:
Authorized Official - Last Name:POSTORINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-679-7185
Mailing Address - Street 1:707 ALEXANDER RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6331
Mailing Address - Country:US
Mailing Address - Phone:973-679-7185
Mailing Address - Fax:
Practice Address - Street 1:707 ALEXANDER RD
Practice Address - Street 2:SUITE 208
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6331
Practice Address - Country:US
Practice Address - Phone:973-679-7185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00566500103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty