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Organization
SULLIVAN COUNTY MEDICAL SERVICES PC
Active
Organization
SULLIVAN COUNTY MEDICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NINA MARIE TIOLECO MD (SOLE SHAREHOLDER)
(347) 387-3873
Entity
Organization
Contact information
Practice address
606 OLD ROUTE 17, MONTICELLO, NY 12701-7013
(845) 707-8400
(845) 404-8189
Mailing address
PO BOX 840, HARRIS, NY 12742-0840
(845) 707-8532
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
224ZF0002X
Feeding, Eating & Swallowing Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
06/11/2020
Last updated
08/05/2022
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