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General NPI Number Information
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NPI Number | 1417407628
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Entity Type | Organization
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Legal Business Name | GUY PASCULLI LCSW PC
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Dates
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Enumeration Date | 10/12/2016
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Last Update Date | 10/12/2016
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Provider Practice Location Address
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Address Line | 200 W 18TH ST APT 5H
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City | NEW YORK
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State | NY
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Zip | 10011-4521
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Country | US
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Telephone | 212-929-5729
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Fax |
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Provider Business Mailing Address
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Address Line | 200 WEST 18TH STREET, 5H
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City | NEW YORK
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State | NY
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Zip | 10011
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Country | US
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Telephone | 212-929-5729
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GUY C PASCULLI
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Credential | LCSW
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Telephone | 212-929-5729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 070332
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License Number State | NY
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