Provider Demographics
NPI:1912146762
Name:LOFU, PIETRO (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PIETRO
Middle Name:
Last Name:LOFU
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-3850
Mailing Address - Country:US
Mailing Address - Phone:347-403-2209
Mailing Address - Fax:718-232-5613
Practice Address - Street 1:2155 W 5TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-3850
Practice Address - Country:US
Practice Address - Phone:347-403-2209
Practice Address - Fax:718-232-5613
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017838-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical