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General NPI Number Information
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NPI Number | 1821145004
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Entity Type | Individual
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Provider Name | ROBERTO TOLEDO LCSW
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Gender | Male
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 376 HANCOCK ST
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City | BRENTWOOD
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State | NY
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Zip | 11717-2854
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Country | US
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Telephone | 631-334-4299
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Fax | 866-422-9552
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Provider Business Mailing Address
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Address Line | 253 FELLER DR
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City | CENTRAL ISLIP
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State | NY
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Zip | 11722-1213
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Country | US
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Telephone | 631-334-4299
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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 | 075458-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 068017-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 17158
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License Number State | LA
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