Provider Demographics
NPI:1558446716
Name:SIROF, BETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:
Last Name:SIROF
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MAIN ST
Mailing Address - Street 2:SUITE 323
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-1762
Mailing Address - Country:US
Mailing Address - Phone:914-924-3607
Mailing Address - Fax:
Practice Address - Street 1:10 MAIN ST
Practice Address - Street 2:SUITE 323
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1762
Practice Address - Country:US
Practice Address - Phone:914-924-3607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY68-015642103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical