Provider Demographics
NPI:1851333264
Name:BOTTARINI, SYLVIA A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:A
Last Name:BOTTARINI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 TANAGER RD
Mailing Address - Street 2:APT. 3
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-1834
Mailing Address - Country:US
Mailing Address - Phone:845-783-4513
Mailing Address - Fax:
Practice Address - Street 1:14461 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-6252
Practice Address - Country:US
Practice Address - Phone:718-939-8700
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0716991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical