Individual
DR. GASPER COLLETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
46 RIVERSIDE DR, BINGHAMTON, NY 13905-4511
(607) 772-1766
(607) 772-2091
Mailing address
46 RIVERSIDE DR, BINGHAMTON, NY 13905-4511
(607) 772-1766
(607) 772-2091
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
006235
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00852295
—
NY
Enumeration date
10/12/2006
Last updated
10/04/2012
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