Provider Demographics
NPI:1396875696
Name:SCOLAMIERO, BERNADETTE T (PSYD)
Entity type:Individual
Prefix:DR
First Name:BERNADETTE
Middle Name:T
Last Name:SCOLAMIERO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 CONGER ST
Mailing Address - Street 2:STE 103B
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3340
Mailing Address - Country:US
Mailing Address - Phone:973-680-4343
Mailing Address - Fax:
Practice Address - Street 1:40 CONGER ST
Practice Address - Street 2:STE 103B
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3340
Practice Address - Country:US
Practice Address - Phone:973-680-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2360103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist