Provider Demographics
NPI:1346200490
Name:PIERRO, ROBERT A (PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:PIERRO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 6TH ST APT 8E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3666
Mailing Address - Country:US
Mailing Address - Phone:718-780-3775
Mailing Address - Fax:718-780-3774
Practice Address - Street 1:506 6TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215
Practice Address - Country:US
Practice Address - Phone:718-780-3139
Practice Address - Fax:718-780-3774
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009607103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01333980Medicaid
NYV4A801Medicare ID - Type Unspecified
NY01333980Medicaid