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General NPI Number Information
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NPI Number | 1467134593
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Entity Type | Individual
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Provider Name | DECLAN TOCHI AMADI MSW
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Gender | Male
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 2578 BROADWAY UNIT 607
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City | NEW YORK
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State | NY
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Zip | 10025
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Country | US
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Telephone | 516-847-5432
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Fax |
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Provider Business Mailing Address
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Address Line | 1827 W GOWAN ROAD UNIT 2178
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032
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Country | US
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Telephone | 952-219-2177
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 31954
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License Number State | MN
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