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General NPI Number Information
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NPI Number | 1982544383
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Entity Type | Organization
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Legal Business Name | CECILY PORTILLO PSYCHOLOGIST PLLC
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Dates
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Enumeration Date | 03/30/2026
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Last Update Date | 03/30/2026
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Provider Practice Location Address
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Address Line | 233 7TH ST STE 200
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City | GARDEN CITY
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State | NY
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Zip | 11530-5747
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Country | US
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Telephone | 631-319-0942
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Fax |
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Provider Business Mailing Address
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Address Line | 222 LINCOLN AVE
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City | MINEOLA
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State | NY
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Zip | 11501-2543
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Country | US
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Telephone | 631-877-9735
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER/PSYCHOLOGIST
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Name | DR. CECILY PORTILLO
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Credential | PHD
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Telephone | 631-877-9735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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