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General NPI Number Information
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NPI Number | 1699005553
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Entity Type | Individual
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Provider Name | CARROL SAVITRI BISSOONDIAL
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Gender | Female
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Dates
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Enumeration Date | 12/28/2009
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Last Update Date | 06/13/2014
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Provider Practice Location Address
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Address Line | 9729 64TH RD
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City | REGO PARK
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State | NY
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Zip | 11374-2259
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Country | US
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Telephone | 718-896-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 8780 97TH ST
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City | WOODHAVEN
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State | NY
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Zip | 11421-2254
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Country | US
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Telephone | 917-842-2468
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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 | 081498
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License Number State | NY
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