Provider Demographics
NPI:1003982885
Name:LIVOTI, THOMAS F (MSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:F
Last Name:LIVOTI
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 LONGNECK BLVD
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-4004
Mailing Address - Country:US
Mailing Address - Phone:631-348-2754
Mailing Address - Fax:631-369-6180
Practice Address - Street 1:238 LONGNECK BLVD
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-4004
Practice Address - Country:US
Practice Address - Phone:631-348-2754
Practice Address - Fax:631-369-6180
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR035070-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY299193OtherMAGNACARE
NYP4426589OtherOXFORD HEALTH PLANS
NY5296332OtherAETNA
NY228226POtherH.I.P.
NY035070OtherHEALTHFIRST
NY29951OtherVYTRA
NY214026OtherMANAGED HEALTH NETWORK
NYN52971Medicare ID - Type Unspecified