Provider Demographics
NPI:1326844226
Name:IADAROLA, MICHAEL
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:IADAROLA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:MICKIE
Other - Middle Name:
Other - Last Name:IADAROLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2348 121ST ST
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-2571
Mailing Address - Country:US
Mailing Address - Phone:917-960-6274
Mailing Address - Fax:
Practice Address - Street 1:2348 121ST ST
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-2571
Practice Address - Country:US
Practice Address - Phone:917-960-6274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health