Provider Demographics
NPI:1619542313
Name:SAVELLO, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:SAVELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-2122
Mailing Address - Country:US
Mailing Address - Phone:516-780-2847
Mailing Address - Fax:
Practice Address - Street 1:247 N 3RD ST
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-2122
Practice Address - Country:US
Practice Address - Phone:516-780-2847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist