Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 35S100299100 | NJ |
NPI | 1093868135 |
---|---|
Provider Name | Dr. Joseph Peter Pedoto |
First Address | Montclair, NJ 07042-2859 |
Second Address | Montclair, NJ 07042-2859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2007 |
Last Update Date | 08/07/2007 |