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NPI Code Detail

MEDICARE: STACEY LYNN TROTTI LCSW

MEDICARE:   STACEY LYNN TROTTI  LCSW
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
11041C0700XClinical Social Worker069601NY

General Provider Information

NPI Number : 1699762534
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY LYNN TROTTI LCSW
Provider Business Mailing Address
First Line : 1355 PARK AVE
Second Line :
City : MERRICK
State : NY
Zip : 11566-1837
Country : US
Telephone Number : 516-208-3277
Fax Number :
Provider Business Practice Location Address
First Line : 2277 GRAND AVE
Second Line :
City : BALDWIN
State : NY
Zip : 11510-3148
Country : US
Telephone Number : 516-546-1370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2005
Last Update Date : 11/12/2008

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Directions to “ STACEY LYNN TROTTI LCSW” Practice Location

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