Amy Antoniazzi, LCSW-R
Individual provider Active NPI Social Worker · Merrick, NY
NPI 1003244476 · NPPES record last updated Oct 23, 2013
Key facts
- NPI
- 1003244476
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- R040238 (NY)
- Practice address
- 1709 Michael William Rd
Merrick, NY 11566-2523 - Phone
- (516) 378-3115
- NPI assigned
- Oct 23, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R040238 | NY | MD | Social Worker |
| 040238 | NY | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | R040238 | NY | Yes |
Addresses
Primary practice location
1709 Michael William Rd
Merrick, NY 11566-2523
Mailing address
1709 Michael William Rd
Merrick, NY 11566-2523
Phone (516) 378-3115
Other providers in Merrick, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.