MARY JO PENIZOTTO PHD NPI 1386094126

NPI Information

  • NPI: 1386094126
  • Provider Name: MARY JO PENIZOTTO, PHD
  • Classification: Clinic/Center - 261QM0850X
  • Specialization: Adult Mental Health
  • Entity Type: Organization
  • Address: 6507 TRANSIT RD
    STE B
    EAST AMHERST, NY
    ZIP 14051
  • Phone: (716) 204-0100

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NPI Details

MARY JO PENIZOTTO, PHD is an adult mental health clinic center in East Amherst, NY. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. MARY JO PENIZOTTO, PHD NPI is 1386094126. The provider is registered as an organization entity type.

The provider's business location address is:

6507 TRANSIT RD
STE B
EAST AMHERST, NY
ZIP 14051-427
Phone: (716) 204-0100
Fax: (716) 204-2761

The provider's authorized official is Mary Jo Penizotto .
The authorized official title is Licensed Psychologist and has the following contact phone number (716) 204-0100.

The enumeration date for this NPI number is 6/13/2016 and was last updated on 6/13/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental Health010373-1NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1J300000263MEDICARE UPINNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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