Mario Brajuha, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

081296-1 Issued in NY

Practice address

2233 Nesconset Hwy
Lake Grove, NY 11755-1000

Phone

(631) 737-5559

Fax

(631) 737-0001

NPI assigned

Apr 8, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441324800000",
    "number": "1255574141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 NESCONSET HWY",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551000",
            "telephone_number": "631-737-5559",
            "fax_number": "631-737-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 NESCONSET HWY",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117551000",
            "telephone_number": "631-737-5559",
            "fax_number": "631-737-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAJUHA",
        "first_name": "MARIO",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-08",
        "last_updated": "2015-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081296-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1528223401",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derek Bershad, PT, DPT
• Melissa Ann Biamonte, OT REGISTERED
• Jacques S. J. Blanchard, D.P.T.,
• Marcia Blatt, MA
• Robert Joseph Boswell, MD
• Edward M Bram, D.M.D.
• Robert Branca, DDS
• Dawn P Brauer, M.S.P.T., C.I.M.I.
• Andrew Zotos Breslin, LMSW
• Brian K. Berliner, O.D., P.C.

• Clinical Social Worker in Lake Grove, NY
• Providers in Lake Grove, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; 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.