Doctor Name: | DR. AVIS PITKOW |
NPI Number: | 1144643883 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD. |
License Number: | PC007041 |
Business Practice Address: | 3140 Main St Green Lane, PA - 180542267 |
Business Phone Number: | 2677169837 |
Business Fax Number: | |
Mailing Address: | 3140 Main St, GREEN LANE |
State: | PA |
Postal Code: | 180542267 |
Phone Number: | 2677169837 |
Fax Number: | |
NPI Enumeration Date: | 01/31/2014 |
NPI Last Update Date: | 01/31/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC007041 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |