Provider Demographics
NPI:1265874101
Name:LATTARULO, OLGA ARMINDA (LMSW)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:ARMINDA
Last Name:LATTARULO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10850 62ND DR
Mailing Address - Street 2:SUITE LA
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1261
Mailing Address - Country:US
Mailing Address - Phone:718-896-8000
Mailing Address - Fax:718-896-8009
Practice Address - Street 1:10850 62ND DR
Practice Address - Street 2:SUITE LA
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1261
Practice Address - Country:US
Practice Address - Phone:718-896-8000
Practice Address - Fax:718-896-8009
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083172104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY083172OtherLICENSE