| Doctor Name: | DR. ANTHONY MICHAEL IACOVELLI |
| NPI Number: | 1346532249 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | |
| Business Practice Address: | 380 Route 202 Somers, NY - 105893222 |
| Business Phone Number: | 5162793403 |
| Business Fax Number: | 5164414270 |
| Mailing Address: | 380 Route 202, SOMERS |
| State: | NY |
| Postal Code: | 105893222 |
| Phone Number: | 5162793403 |
| Fax Number: | 5164414270 |
| NPI Enumeration Date: | 05/10/2011 |
| NPI Last Update Date: | 11/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |