Healthcare Provider Details

I. General information

NPI: 1558287474
Provider Name (Legal Business Name): ANNETTE ANGIOLILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 NORTH ST STE 406
WHITE PLAINS NY
10605-2232
US

IV. Provider business mailing address

1400 OLD COUNTRY RD STE C103N
WESTBURY NY
11590-5156
US

V. Phone/Fax

Practice location:
  • Phone: 914-898-5117
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: