Provider Demographics
NPI:1598295388
Name:BARTOLOTTA, GIOVANNI (PA)
Entity Type:Individual
Prefix:
First Name:GIOVANNI
Middle Name:
Last Name:BARTOLOTTA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2534 CRUGER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-8220
Mailing Address - Country:US
Mailing Address - Phone:917-717-4952
Mailing Address - Fax:
Practice Address - Street 1:8325 5TH AVE APT 1A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-4537
Practice Address - Country:US
Practice Address - Phone:718-745-4288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084707-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical