Individual
DR. ANTHONY MICHAEL IACOVELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
380 ROUTE 202, SOMERS, NY 10589-3222
(516) 279-3403
(516) 441-4270
Mailing address
380 ROUTE 202, SOMERS, NY 10589-3222
(516) 279-3403
(516) 441-4270
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
020258
NY
103TC2200X
Clinical Child & Adolescent Psychologist
020258
NY
103TS0200X
School Psychologist
—
—
Other
Enumeration date
05/10/2011
Last updated
11/26/2014
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