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General NPI Number Information
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NPI Number | 1730721531
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Entity Type | Individual
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Provider Name | RAYANA ANGELILLO LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/13/2019
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 77 N CENTRE AVE STE 310
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-3923
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Country | US
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Telephone | 516-740-1950
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Fax |
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Provider Business Mailing Address
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Address Line | 3559 BAYFIELD BLVD
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City | OCEANSIDE
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State | NY
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Zip | 11572-4625
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Country | US
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Telephone | 516-754-3489
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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 | 106832
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 095288
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License Number State | NY
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