Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS000334L | PA |
Y | 103T00000X | Psychologist | PS000334L | PA |
NPI | 1003915786 |
---|---|
Provider Name | Peter J Garito |
First Address | Lebanon, PA 17042-9098 |
Second Address | Lebanon, PA 17042-9098 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 08/07/2007 |