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Organization
NORTH CAROLINA NEUROPSYCHIATRY
Active
Organization
NORTH CAROLINA NEUROPSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILLO THOMAS GUALTIERI MD (MEDICAL DIRECTOR)
(919) 785-5055
Entity
Organization
Contact information
Practice address
13251 FALLS OF NEUSE RD STE 121, RALEIGH, NC 27614
(919) 785-5055
(984) 235-1617
Mailing address
13251 FALLS OF NEUSE RD STE 121, RALEIGH, NC 27614-8573
(919) 785-5055
(984) 235-1617
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
NULL
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
NULL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Enumeration date
09/07/2010
Last updated
02/23/2023
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