Individual
DR. LAVERN K COLE-RISTUCCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY D PC
Contact information
Practice address
5 S PITTSFORD HILL LANE, ROCHESTER, NY 14618-2894
(585) 507-2181
(585) 385-9315
Mailing address
5 S PITTSFORD HILL LN, ROCHESTER, NY 14618
(585) 507-2181
(585) 385-9315
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
NY012985
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010012985
BCBS
NY
05
—
01733782
—
NY
01
—
P010012985
BLUE CHOICE
NY
01
—
P102037FC
PREFERRED CARE
NY
Enumeration date
08/26/2006
Last updated
05/26/2022
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