Healthcare Provider Details

I. General information

NPI: 1619283918
Provider Name (Legal Business Name): CATHERINE VECCHIARELLI SCHOOL PSYCHOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE MCDONALD

II. Dates (important events)

Enumeration Date: 08/24/2010
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 SUMMIT AVE
STATEN ISLAND NY
10306-1352
US

IV. Provider business mailing address

121 DOGWOOD LN
STATEN ISLAND NY
10305-2812
US

V. Phone/Fax

Practice location:
  • Phone: 718-979-5678
  • Fax:
Mailing address:
  • Phone: 646-296-3771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1198208
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: