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General NPI Number Information
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NPI Number | 1063987089
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Entity Type | Individual
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Provider Name | JENNIFER TORCHETTI PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/05/2018
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Last Update Date | 10/05/2018
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Provider Practice Location Address
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Address Line | 90 AIR PARK DR
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City | RONKONKOMA
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State | NY
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Zip | 11779-7360
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Country | US
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Telephone | 631-580-4047
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Fax |
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Provider Business Mailing Address
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Address Line | 115 BRENNER AVE
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City | BETHPAGE
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State | NY
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Zip | 11714-4303
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Country | US
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Telephone | 516-695-3812
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | P11711
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License Number State | NY
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