Provider Demographics
NPI:1609916261
Name:LOTTO, SUSAN MARIA (PH D, CASAC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARIA
Last Name:LOTTO
Suffix:
Gender:F
Credentials:PH D, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 E 102ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-2607
Mailing Address - Country:US
Mailing Address - Phone:718-272-9529
Mailing Address - Fax:
Practice Address - Street 1:971 JEROME ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-9252
Practice Address - Country:US
Practice Address - Phone:718-272-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012572-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist