Provider Demographics
NPI:1124615034
Name:PIETRUSZA, CELESTE (PHD)
Entity type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:
Last Name:PIETRUSZA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W 149TH ST APT 67
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-3157
Mailing Address - Country:US
Mailing Address - Phone:917-773-7228
Mailing Address - Fax:
Practice Address - Street 1:89 FORT GREENE PL FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1203
Practice Address - Country:US
Practice Address - Phone:917-773-7228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-26
Last Update Date:2020-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024108103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical