Provider Demographics
NPI:1346274412
Name:DELLA TOFFALO, DOUGLAS ANTHONY (PHD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:ANTHONY
Last Name:DELLA TOFFALO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:441 PFEIFER ROAD
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:PA
Mailing Address - Zip Code:16052-2607
Mailing Address - Country:US
Mailing Address - Phone:724-496-5717
Mailing Address - Fax:724-368-3006
Practice Address - Street 1:605 MAIN ST
Practice Address - Street 2:SUITE 302
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901
Practice Address - Country:US
Practice Address - Phone:724-496-5717
Practice Address - Fax:724-368-3006
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015346103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist