Provider Demographics
NPI:1467849786
Name:BETH CERRITO PHD PSYCHOLOGIST PC
Entity Type:Organization
Organization Name:BETH CERRITO PHD PSYCHOLOGIST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CERRITO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:585-737-7447
Mailing Address - Street 1:1357 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-1005
Mailing Address - Country:US
Mailing Address - Phone:585-442-9601
Mailing Address - Fax:585-442-9606
Practice Address - Street 1:1357 MONROE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-1005
Practice Address - Country:US
Practice Address - Phone:585-442-9601
Practice Address - Fax:585-442-9606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018331103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty