Mary Jo Penizotto, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0103731 Issued in NY

Practice address

6507 Transit Rd
Suite B
East Amherst, NY 14051-1427

Phone

(716) 204-0100

Fax

(716) 204-2761

NPI assigned

Aug 18, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mary Jo Penizotto, PHD

  • Adult Mental Health Clinic/Center
  • East Amherst, NY
  • NPI 1386094126
  NPD (past) Authorized official

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224892800000",
    "number": "1679565386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 TRANSIT RD",
            "address_2": "SUITE B",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140511427",
            "telephone_number": "716-204-0100",
            "fax_number": "716-204-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 TRANSIT RD",
            "address_2": "SUITE B",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140511427",
            "telephone_number": "716-204-0100",
            "fax_number": "716-204-2761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENIZOTTO",
        "first_name": "MARY JO",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2008-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0103731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Marie Parker, COTA
• Taylore A Passero, PA
• Path to Wellness Adult Health Nurse Practitioner Services
• Andrea Pecoraro
• Wendy Bottoms Pegan, LMHC
• Kelley Perkins
• Carolyn Maureen Petko, D.C.
• Philip J Young DDS PLLC
• Laura Rose Picano
• Kayla Nicole Pierce, PA-C

• Clinical Psychologist in East Amherst, NY
• Providers in East Amherst, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2008; 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.