Provider Demographics
NPI:1801132550
Name:GARITI, PETER WILLIAM (PHD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:WILLIAM
Last Name:GARITI
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 1:90 BAYBERRY LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-2708
Mailing Address - Country:US
Mailing Address - Phone:610-935-1929
Mailing Address - Fax:610-933-0471
Practice Address - Street 1:90 BAYBERRY LN
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-2708
Practice Address - Country:US
Practice Address - Phone:610-935-1929
Practice Address - Fax:610-933-0471
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW-001150-L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical