Provider Demographics
NPI:1144422973
Name:PEDRELLI, PAOLA (PHD)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:
Last Name:PEDRELLI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSYCHIATRY
Mailing Address - Street 2:50 STANIFORD STREET, 401A
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-724-3678
Mailing Address - Fax:
Practice Address - Street 1:PSYCHIATRY
Practice Address - Street 2:50 STANIFORD STREET, 401A
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-724-3678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8866103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist