Provider Demographics
NPI:1316047905
Name:GREGG A PIZZI PSY D & ASSOCIATES PLLC
Entity type:Organization
Organization Name:GREGG A PIZZI PSY D & ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR & LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:A
Authorized Official - Last Name:PIZZI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:888-377-4994
Mailing Address - Street 1:432 S WASHINGTON AVE
Mailing Address - Street 2:SUITE 1207
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3854
Mailing Address - Country:US
Mailing Address - Phone:888-377-4994
Mailing Address - Fax:888-377-4994
Practice Address - Street 1:432 S WASHINGTON AVE
Practice Address - Street 2:SUITE 1207
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-3854
Practice Address - Country:US
Practice Address - Phone:888-377-4994
Practice Address - Fax:888-377-4994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-23
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6018103T00000X
MI6301011945103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7295183OtherAETNA
MI68-0-F3-2477-0OtherBLUE CROSS BLUE SHIELD
MI68-0-F3-2477-0OtherBLUE CROSS BLUE SHIELD