Provider Demographics
NPI:1073793014
Name:TORAZZO, PAMELA VICTORIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:VICTORIA
Last Name:TORAZZO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:TORAZZO
Other - Last Name:AZAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108-22 72ND AVENUE
Mailing Address - Street 2:#4A
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5384
Mailing Address - Country:US
Mailing Address - Phone:718-268-4061
Mailing Address - Fax:
Practice Address - Street 1:108-22 72ND AVENUE
Practice Address - Street 2:#4A
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5384
Practice Address - Country:US
Practice Address - Phone:718-268-4061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0716441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07564Medicare PIN