Provider Demographics
NPI:1407582935
Name:LIKKOLA, SILVANA
Entity Type:Individual
Prefix:
First Name:SILVANA
Middle Name:
Last Name:LIKKOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 BAY ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3169
Mailing Address - Country:US
Mailing Address - Phone:718-982-4774
Mailing Address - Fax:718-420-0613
Practice Address - Street 1:1216 BAY ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3169
Practice Address - Country:US
Practice Address - Phone:718-982-4774
Practice Address - Fax:718-420-0613
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical