Individual provider Active NPI

Mary Gnieser, LCSW

  • Clinical Social Worker
  • Commack, NY
National Provider Identifier
1083854202
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
73 080458 Issued in NY
Practice address
340 Veterans Memorial Hwy
Suite 12
Commack, NY 11725-4300
Phone
(631) 680-4278
NPI assigned
Feb 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 73 080458 NY Primary

Addresses

Primary practice location

340 Veterans Memorial Hwy
Suite 12
Commack, NY 11725-4300

Mailing address

340 Veterans Memorial Hwy
Suite 12
Commack, NY 11725-4300
Phone (631) 680-4278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
73 080458NYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1083854202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 12",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254300",
            "telephone_number": "631-680-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 12",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254300",
            "telephone_number": "631-680-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GNIESER",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-27",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73 080458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.