Provider Demographics
NPI:1649547464
Name:FITOUSSI, NADINE (PSYD)
Entity type:Individual
Prefix:DR
First Name:NADINE
Middle Name:
Last Name:FITOUSSI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SANDS POINT RD
Mailing Address - Street 2:SOUSA ELEMENTARY SCHOOL
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1641
Mailing Address - Country:US
Mailing Address - Phone:516-767-5361
Mailing Address - Fax:
Practice Address - Street 1:101 SANDS POINT RD
Practice Address - Street 2:SOUSA ELEMENTARY SCHOOL
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-1641
Practice Address - Country:US
Practice Address - Phone:516-767-5361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019215103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool