Doctor Name: | MR. JOSEPH PEPE |
NPI Number: | 1235397266 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MHC |
License Number: | P63894 |
Business Practice Address: | 595 Route 25a Suite 20 Miller Place, NY - 117642646 |
Business Phone Number: | 6317445500 |
Business Fax Number: | 6317445677 |
Mailing Address: | 595 Route 25a, Suite 20 MILLER PLACE |
State: | NY |
Postal Code: | 117642646 |
Phone Number: | 6317445500 |
Fax Number: | 6317445677 |
NPI Enumeration Date: | 05/27/2008 |
NPI Last Update Date: | 05/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | P63894 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |