Healthcare Provider Details

I. General information

NPI: 1821771957
Provider Name (Legal Business Name): KRISTINA GARRITANO HOTI LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 ROUTE 17M
MIDDLETOWN NY
10940-4525
US

IV. Provider business mailing address

480 ROUTE 17M
MIDDLETOWN NY
10940-4525
US

V. Phone/Fax

Practice location:
  • Phone: 845-239-4541
  • Fax: 845-381-1313
Mailing address:
  • Phone: 845-239-4541
  • Fax: 845-381-1313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberP123387
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number121687-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: