Basic Information
Provider Information
NPI: 1609938653
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAPOLI
FirstName: LOREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SHELDEN
OtherFirstName: LOREN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1156 N BROADWAY
Address2: ANDRUS CHILDREN'S CENTER
City: YONKERS
State: NY
PostalCode: 107011108
CountryCode: US
TelephoneNumber: 9149653700
FaxNumber: 9149653883
Practice Location
Address1: 30 S BROADWAY
Address2: ANDRUS CHILDREN'S CENTER
City: YONKERS
State: NY
PostalCode: 107013712
CountryCode: US
TelephoneNumber: 9149681663
FaxNumber: 9149681664
Other Information
ProviderEnumerationDate: 12/15/2006
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

ID Information
IDTypeStateIssuerDescription
0035594005NY MEDICAID
128562855201NYAGENCY NPI #OTHER


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