Antonuccio, David

Antonuccio, David is an individual health care provider with primary practice located at 401 W 2Nd St Ste 216 , Reno NV 89503-5353. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Antonuccio, David can be contacted via phone (775) 784-6388.

Contact Information

Primary practice address
401 W 2Nd St Ste 216 Reno NV 89503-5353
Fax: (775) 784-1428
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PY104 Nevada

Profile Details

NPI number 1730293457
LBN Legal business name Antonuccio, David
Credentials P.H.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2006
Last updated Dec 16th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730293457 NPPES
Nevada MEDICAID 002616051

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