Provider Demographics
NPI:1891274262
Name:ALIOTTA, TERESA (MED, MSW, NCC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:ALIOTTA
Suffix:
Gender:F
Credentials:MED, MSW, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 PAGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-7500
Mailing Address - Country:US
Mailing Address - Phone:845-486-2950
Mailing Address - Fax:
Practice Address - Street 1:41 PAGE PARK DR
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-7500
Practice Address - Country:US
Practice Address - Phone:845-486-2950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY41876101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
41876OtherNATIONAL COUNSELOR CERTIFICATION