Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 13192 | NY |
Y | 101YM0800X | Mental Health Counselor | 067599 | NY |
N | 1041C0700X | Clinical Social Worker | 082493 | NY |
NPI | 1013030972 |
---|---|
Provider Name | Mr. Nunzio Signorella |
First Address | New York, NY 10023-2661 |
Second Address | New York, NY 10023-2661 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2007 |
Last Update Date | 31/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02542107 | (05) | NY |
Q03275 | (02) | NY |