Healthcare Provider Details

I. General information

NPI: 1710731518
Provider Name (Legal Business Name): GIULIANA FICUCIELLO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 N BROADWAY
SLEEPY HOLLOW NY
10591-2674
US

IV. Provider business mailing address

65 HOWARD AVE
EASTCHESTER NY
10709-2714
US

V. Phone/Fax

Practice location:
  • Phone: 914-631-2022
  • Fax:
Mailing address:
  • Phone: 914-364-2271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number123193-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: