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General NPI Number Information
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NPI Number | 1558668079
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Entity Type | Individual
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Provider Name | ALEJANDRO CESAR SCIAMMARELLA PHD
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Gender | Male
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Dates
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Enumeration Date | 02/18/2011
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Last Update Date | 02/18/2011
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Provider Practice Location Address
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Address Line | 155 3RD AVE
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City | BAY SHORE
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State | NY
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Zip | 11706-6636
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Country | US
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Telephone | 631-968-1171
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Fax |
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Provider Business Mailing Address
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Address Line | 3 KIM PL
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City | KINGS PARK
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State | NY
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Zip | 11754-5025
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Country | US
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Telephone | 631-544-0864
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 008787-1
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License Number State | NY
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