Provider Demographics
NPI:1568947588
Name:CIRIGLIANO, JOSEPH ROBERT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ROBERT
Last Name:CIRIGLIANO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:ROBERT
Other - Last Name:CIRIGLIANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:11303 GATEWAY CT
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-5555
Mailing Address - Country:US
Mailing Address - Phone:917-498-0346
Mailing Address - Fax:
Practice Address - Street 1:115 W 30TH ST RM 709
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4068
Practice Address - Country:US
Practice Address - Phone:347-927-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022893103TC0700X
MEPS2004103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical