Provider Demographics
NPI:1871846576
Name:TOMASELLI, RICHARD PETER (MA, MS)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:PETER
Last Name:TOMASELLI
Suffix:
Gender:M
Credentials:MA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 PITTSFORD MENDON CENTER RD
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-9364
Mailing Address - Country:US
Mailing Address - Phone:585-582-1561
Mailing Address - Fax:
Practice Address - Street 1:1232 PITTSFORD MENDON CENTER RD
Practice Address - Street 2:
Practice Address - City:HONEOYE FALLS
Practice Address - State:NY
Practice Address - Zip Code:14472-9364
Practice Address - Country:US
Practice Address - Phone:585-582-1561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001780101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY001780OtherNEW YORK STATE