Provider Demographics
NPI:1215140512
Name:LIOTTA, ANTHONY J (MSW)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:J
Last Name:LIOTTA
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8423 114TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1344
Mailing Address - Country:US
Mailing Address - Phone:718-805-8852
Mailing Address - Fax:
Practice Address - Street 1:8423 114TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1344
Practice Address - Country:US
Practice Address - Phone:718-805-8852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019562 -1R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical