Provider Demographics
NPI:1154533172
Name:RECINIELLO, SHELLEY (PHD)
Entity type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:
Last Name:RECINIELLO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 W 48TH ST
Mailing Address - Street 2:SUITE 34E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-1404
Mailing Address - Country:US
Mailing Address - Phone:212-581-7255
Mailing Address - Fax:212-541-9518
Practice Address - Street 1:235 W 48TH ST
Practice Address - Street 2:SUITE 34E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-1404
Practice Address - Country:US
Practice Address - Phone:212-581-7255
Practice Address - Fax:212-541-9518
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009418-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist