Healthcare Provider Details

I. General information

NPI: 1285822056
Provider Name (Legal Business Name): ANDREW JAMES CIOTTI NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2007
Last Update Date: 06/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1167 NOSTRAND AVE
BROOKLYN NY
11225-5417
US

IV. Provider business mailing address

366 BROADWAY BLDG 5
AMITYVILLE NY
11701-2711
US

V. Phone/Fax

Practice location:
  • Phone: 718-778-0198
  • Fax: 718-221-8169
Mailing address:
  • Phone: 718-460-2046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number401250
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: