Individual
DR. MICHAEL JOSEPH CANZONIERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
4 SALTY WAY, SHOREHAM, NY 11786-1146
(631) 821-2773
(631) 821-2773
Mailing address
4 SALTY WAY, SHOREHAM, NY 11786-1146
(631) 821-2773
(631) 821-2773
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
006227-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4348117
AETNA PROVIDER ID
NY
01
—
6894081
VALUE OPTIONS PROVIDER ID
NY
Enumeration date
09/27/2006
Last updated
07/08/2007
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