Provider Demographics
NPI:1386737757
Name:PIEGARI, JAMES A (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:PIEGARI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 AZALEA CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-1633
Mailing Address - Country:US
Mailing Address - Phone:718-948-6233
Mailing Address - Fax:
Practice Address - Street 1:7 AZALEA CT
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-1633
Practice Address - Country:US
Practice Address - Phone:718-948-6233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015064103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02496606Medicaid
NYP65577Medicare UPIN
NYVL7631Medicare ID - Type UnspecifiedPROVIDER NUMBER