MEDICARE: NICHOLAS V TORNATORE MENTAL HEALTH COUNSELOR PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	000150	NY

General Provider Information

NPI Number	:	1588681506
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NICHOLAS V TORNATORE MENTAL HEALTH COUNSELOR PC

Provider Business Mailing Address
First Line	:	585 BAY RIDGE PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-3309
Country	:	US
Telephone Number	:	718-745-2911
Fax Number	:	718-492-2777

Provider Business Practice Location Address
First Line	:	585 BAY RIDGE PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-3309
Country	:	US
Telephone Number	:	718-745-2911
Fax Number	:	718-492-2777

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NICHOLAS V TORNATORE
Credential	:	PH.D.
Telephone Number	:	718-745-2911

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	01/24/2012

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