Provider Demographics
NPI:1497977409
Name:TUOSTO, JOHN S (MSW)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:TUOSTO
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 1:123 W CLEARWATER RD
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-6439
Mailing Address - Country:US
Mailing Address - Phone:631-226-0008
Mailing Address - Fax:631-226-0008
Practice Address - Street 1:123 W CLEARWATER RD
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-6439
Practice Address - Country:US
Practice Address - Phone:631-226-0008
Practice Address - Fax:631-226-0008
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR039446-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9799OtherCASAC
NYN45553Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER