Healthcare Provider Details

I. General information

NPI: 1093646523
Provider Name (Legal Business Name): MONIQUE TRUCCHIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 WELWYN RD APT 1N
GREAT NECK NY
11021-3525
US

IV. Provider business mailing address

12 WELWYN RD APT 1N
GREAT NECK NY
11021-3525
US

V. Phone/Fax

Practice location:
  • Phone: 516-343-9498
  • Fax: 516-343-9498
Mailing address:
  • Phone: 516-343-9498
  • Fax: 516-343-9498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number131398-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: