Provider Demographics
NPI:1780841163
Name:STROCCHIA-RIVERA, LENORE (PH D)
Entity Type:Individual
Prefix:DR
First Name:LENORE
Middle Name:
Last Name:STROCCHIA-RIVERA
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MILTON AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-1415
Mailing Address - Country:US
Mailing Address - Phone:845-532-1575
Mailing Address - Fax:
Practice Address - Street 1:15 DOGWOOD KNLS
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-2702
Practice Address - Country:US
Practice Address - Phone:845-532-1575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009931103TC2200X, 103TF0000X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily