Provider Demographics
NPI:1558813451
Name:POSTORINO, LIA (PSYD)
Entity Type:Individual
Prefix:
First Name:LIA
Middle Name:
Last Name:POSTORINO
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 1:707 ALEXANDER RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6331
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:707 ALEXANDER RD
Practice Address - Street 2:SUITE 208
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6331
Practice Address - Country:US
Practice Address - Phone:973-679-7185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-26
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021573103TC0700X
NJ35SI00566500103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical