Provider Demographics
NPI:1972862720
Name:SOTTILE, GIUSEPPE (PHD)
Entity Type:Individual
Prefix:
First Name:GIUSEPPE
Middle Name:
Last Name:SOTTILE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1928 69TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-4544
Mailing Address - Country:US
Mailing Address - Phone:347-386-5691
Mailing Address - Fax:
Practice Address - Street 1:88 OLD TOWN RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4212
Practice Address - Country:US
Practice Address - Phone:718-979-5000
Practice Address - Fax:718-980-1298
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019523103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical