MEDICARE: DR. JAMES JOSEPH COLANGELO PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	000241-1	NY
2	106H00000X	Marriage & Family Therapist	000260-1	NY

General Provider Information

NPI Number	:	1528275922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES JOSEPH COLANGELO PSY.D.

Provider Business Mailing Address
First Line	:	5344 196TH ST
Second Line	:
City	:	FRESH MEADOWS
State	:	NY
Zip	:	11365-1737
Country	:	US
Telephone Number	:	718-357-3347
Fax Number	:

Provider Business Practice Location Address
First Line	:	10211 81ST ST
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11416-1928
Country	:	US
Telephone Number	:	718-848-3920
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	09/11/2025

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