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General NPI Number Information
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NPI Number | 1821753898
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Entity Type | Individual
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Provider Name | MS. MARISSA L BIONDOLILLO
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Gender | Female
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Dates
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Enumeration Date | 11/04/2021
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 350 JERICHO TPKE STE 103
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City | JERICHO
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State | NY
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Zip | 11753-1317
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Country | US
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Telephone | 516-399-5373
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Fax |
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Provider Business Mailing Address
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Address Line | 2116 DITMAS AVE APT 2A
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City | BROOKLYN
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State | NY
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Zip | 11226-6917
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Country | US
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Telephone | 716-982-4155
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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 | 101976
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License Number State | NY
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