Provider Demographics
NPI:1518747120
Name:LOSITO, ANDREA MICHELE (LCAT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MICHELE
Last Name:LOSITO
Suffix:
Gender:F
Credentials:LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15325 88TH ST APT 1C
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-2101
Mailing Address - Country:US
Mailing Address - Phone:718-744-7666
Mailing Address - Fax:
Practice Address - Street 1:15325 88TH ST APT 1C
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-2101
Practice Address - Country:US
Practice Address - Phone:718-744-7666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002650221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist