Healthcare Provider Details

I. General information

NPI: 1891659199
Provider Name (Legal Business Name): ANGELINA ROCHETTA UBRIACO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4080 HEMPSTEAD TPKE
BETHPAGE NY
11714-5604
US

IV. Provider business mailing address

40 EDWARD ST
LYNBROOK NY
11563-1214
US

V. Phone/Fax

Practice location:
  • Phone: 516-738-4844
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number129704
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: