Provider Demographics
NPI:1568181642
Name:SIVILLI, FRANK J
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:J
Last Name:SIVILLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 W 91ST ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1011
Mailing Address - Country:US
Mailing Address - Phone:212-787-7120
Mailing Address - Fax:
Practice Address - Street 1:302 W 91ST ST APT 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1011
Practice Address - Country:US
Practice Address - Phone:212-787-7120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP116503104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP116503OtherLIMITED LICENSE LMSW