MEDICARE: MRS. PORTIA XOLISWA ALLIE-TURCO

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	004429	NY

General Provider Information

NPI Number	:	1891010450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PORTIA XOLISWA ALLIE-TURCO

Provider Business Mailing Address
First Line	:	16 CROSS RD
Second Line	:
City	:	ESSEX
State	:	NY
Zip	:	12936-1918
Country	:	US
Telephone Number	:	518-963-7122
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 CROSS RD
Second Line	:
City	:	ESSEX
State	:	NY
Zip	:	12936-1918
Country	:	US
Telephone Number	:	518-963-7122
Fax Number	:

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

Provider Enumeration Date	:	04/07/2010
Last Update Date	:	05/13/2010

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