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General NPI Number Information
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NPI Number | 1528338944
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Entity Type | Individual
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Provider Name | CHRISTOPHER MICHAEL TARELLO LMSW
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Gender | Male
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Dates
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Enumeration Date | 01/02/2012
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 518 ISLIP AVE
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City | ISLIP
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State | NY
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Zip | 11751-1508
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Country | US
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Telephone | 631-697-4626
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Fax |
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Provider Business Mailing Address
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Address Line | 518 ISLIP AVE
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City | ISLIP
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State | NY
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Zip | 11751-1508
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Country | US
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Telephone | 631-697-4626
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 114497
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License Number State | NY
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