Provider Demographics
NPI:1497966170
Name:DELROSARIO, PETER MILES (PHD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:MILES
Last Name:DELROSARIO
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 1:27 OUTLOOK FARM DR
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-3615
Mailing Address - Country:US
Mailing Address - Phone:914-262-8595
Mailing Address - Fax:845-256-0432
Practice Address - Street 1:199 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1242
Practice Address - Country:US
Practice Address - Phone:914-262-8595
Practice Address - Fax:845-256-0432
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012249103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling