Healthcare Provider Details

I. General information

NPI: 1083536049
Provider Name (Legal Business Name): PASQUALINA SCOGNAMILLO
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 W 168TH ST
NEW YORK NY
10032-3725
US

IV. Provider business mailing address

890 CRANFORD AVE
VALLEY STREAM NY
11581-3114
US

V. Phone/Fax

Practice location:
  • Phone: 877-426-5637
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: