Robert Henry Pietrzak, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

003183 Issued in CT

Practice address

950 Campbell Ave
151E
West Haven, CT 06516-2770

Phone

(860) 638-7467

NPI assigned

Jul 11, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1508121989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 LYMAN ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060533778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE",
            "address_2": "151E",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162770",
            "telephone_number": "860-638-7467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETRZAK",
        "first_name": "ROBERT",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CT",
            "license": "003183",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003183",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Physical Therapy & Rehabilitation Center LLC
• Physicians Physical Therapy
• Breanne Piazik, PHARMD
• Karen Beth Piecuch
• Maria Bianca Pierce, PA-C
• David T Pilkey, PH.D.
• Vin Sivan Pillai, M.D.
• Maria F Pinto, RPH
• David Cesidio Piselli
• Patricia Ellen Pitkin, APRN

• Clinical Neuropsychologist in West Haven, CT
• Providers in West Haven, CT by specialty
• Clinical Neuropsychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.