| Joseph Vollaro Phd Neuropsychologist Pc | |
|
1461 Lakeland Ave Unit 12 Bohemia NY 11716-2174 | |
| (631) 732-4794 | |
| (631) 732-0355 |
| Full Name | Joseph Vollaro Phd Neuropsychologist Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1461 Lakeland Ave Unit 12, Bohemia, New York |
| Authorized Official Name and Position | Joseph Vollaro (OWNER) |
| Authorized Official Contact | 6317324794 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph Vollaro Phd Neuropsychologist Pc 1461 Lakeland Ave Unit 12 Bohemia NY 11716-2174 Ph: (631) 732-4794 | Joseph Vollaro Phd Neuropsychologist Pc 1461 Lakeland Ave Unit 12 Bohemia NY 11716-2174 Ph: (631) 732-4794 |
| NPI Number | 1053888099 |
|---|---|
| Provider Enumeration Date | 10/29/2018 |
| Last Update Date | 10/29/2018 |
| Medicare PECOS PAC ID | 8729311097 |
|---|---|
| Medicare Enrollment ID | O20190603000000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053888099 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Joseph Vollaro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578659058 PECOS PAC ID: 0547255242 Enrollment ID: I20040420000613 |
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