1225194301 NPI number — REGINA A COLANGELO LCSW

Table of content: REGINA A COLANGELO LCSW (NPI 1225194301)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225194301 NPI number — REGINA A COLANGELO LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLANGELO
Provider First Name:
REGINA
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225194301
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 226
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RYE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10580-0226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-934-8861
Provider Business Mailing Address Fax Number:
914-939-0145

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16 SCHOOL ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
RYE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10580-2952
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-934-8861
Provider Business Practice Location Address Fax Number:
914-939-0145
Provider Enumeration Date:
12/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  PR019095-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: 003252 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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