| David L Marasciullo Ph.d,psychologist, Pc | |
|
18 S Hollow Rd Dix Hills NY 11746-6140 | |
| (631) 643-7390 | |
| (631) 643-5068 |
| Full Name | David L Marasciullo Ph.d,psychologist, Pc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 18 S Hollow Rd, Dix Hills, New York |
| Authorized Official Name and Position | David Louis Marasciullo (CLINICAL DIRECTOR) |
| Authorized Official Contact | 6316437390 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David L Marasciullo Ph.d,psychologist, Pc 18 S Hollow Rd Dix Hills NY 11746-6140 Ph: (631) 643-7390 | David L Marasciullo Ph.d,psychologist, Pc 18 S Hollow Rd Dix Hills NY 11746-6140 Ph: (631) 643-7390 |
| NPI Number | 1518086735 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 05/25/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518086735 | NPI | - | NPPES |
| S0879-4 B | Other | NY | WORKERS' COMPENSATION |
| 3879 | Other | NY | PSYCHOLOGY LICENSE |
| 02927659 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 3879 (New York) | Primary |
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