| Paul J Botticelli Lcsw Pc | |
|
22 Southern Blvd Ste 111 Nesconset NY 11767-1086 | |
| (631) 689-1728 | |
| Not Available |
| Full Name | Paul J Botticelli Lcsw Pc |
|---|---|
| Speciality | Social Worker |
| Location | 22 Southern Blvd Ste 111, Nesconset, New York |
| Authorized Official Name and Position | Paul Botticelli (OWNER) |
| Authorized Official Contact | 6316891728 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul J Botticelli Lcsw Pc 379 Pond Path East Setauket NY 11733-1020 Ph: (631) 987-4817 | Paul J Botticelli Lcsw Pc 22 Southern Blvd Ste 111 Nesconset NY 11767-1086 Ph: (631) 689-1728 |
| NPI Number | 1881294338 |
|---|---|
| Provider Enumeration Date | 10/26/2020 |
| Last Update Date | 04/19/2021 |
| Certification Date | 04/19/2021 |
| Medicare PECOS PAC ID | 1850792516 |
|---|---|
| Medicare Enrollment ID | O20210701001657 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881294338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Paul J Botticelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457499808 PECOS PAC ID: 7517926702 Enrollment ID: I20041004001061 |
Nesconset Medical Associates Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 195 Southern Blvd Ste 104, Nesconset, NY 11767 Phone: 516-808-6333 | |
H&s Enterprise New York Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15 Chivalry Ln, Nesconset, NY 11767 Phone: 929-236-5366 |