Individual provider · NPI-1

Dr. William Iaccino, Ph.D.

Psychologist, Clinical · Babylon, NY

NPI number1376691469
StatusActive
Last updated in NPPESDec 28, 2016

Details

NPI
1376691469
Entity type
Individual (NPI-1)
Name
Dr. William Iaccino
Credential
Ph.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 8, 2007
Last updated
Dec 28, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103TC0700X Psychologist, Clinical014854NYYes

Practice location

74 Fire Island Ave
Babylon, NY 11702-3531

Phone 631-943-5493

Mailing address

2483 Freeport St
Wantagh, NY 11793-4526

Phone 631-943-5493

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