Individual
BASIL NEIL DUCILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17 W MERRICK RD, VALLEY STREAM, NY 11580-5701
(516) 459-2920
(516) 285-1616
Mailing address
16724 145TH DR, JAMAICA, NY 11434-5113
(347) 319-9918
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P13804
NY
Other
Enumeration date
01/05/2022
Last updated
01/05/2022
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