Provider Demographics
NPI:1679768329
Name:PIOLI PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:PIOLI PSYCHOLOGICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD IN CLINICAL PSYC
Authorized Official - Phone:203-366-3570
Mailing Address - Street 1:1495 BLACK ROCK TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825
Mailing Address - Country:US
Mailing Address - Phone:203-366-3570
Mailing Address - Fax:203-459-1967
Practice Address - Street 1:1495 BLACK ROCK TURNPIKE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825
Practice Address - Country:US
Practice Address - Phone:203-366-3570
Practice Address - Fax:203-459-1967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty