Provider Demographics
NPI:1134116023
Name:TOROSSIAN, CAROL L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:L
Last Name:TOROSSIAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CEDAR RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-4401
Mailing Address - Country:US
Mailing Address - Phone:516-621-8005
Mailing Address - Fax:
Practice Address - Street 1:2 CEDAR RIDGE RD
Practice Address - Street 2:
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-4401
Practice Address - Country:US
Practice Address - Phone:516-621-8005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013463103TA0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01922229Medicaid
NY568047Medicare UPIN
NYV81162Medicare ID - Type Unspecified