Provider Demographics
NPI:1497826168
Name:PIRROTTA, SERGIO (EDD)
Entity Type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:
Last Name:PIRROTTA
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 CENTRAL ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:BYFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01922-1233
Mailing Address - Country:US
Mailing Address - Phone:978-463-0090
Mailing Address - Fax:
Practice Address - Street 1:19 CENTRAL ST
Practice Address - Street 2:SUITE D
Practice Address - City:BYFIELD
Practice Address - State:MA
Practice Address - Zip Code:01922-1233
Practice Address - Country:US
Practice Address - Phone:978-463-0090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4606103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical