Active NPI
Elizabeth Antonio, CLINICAL SOCIAL
- Clinical Social Worker
- Bronx, NY
National Provider Identifier
1376680835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 064839
- Practice address
- 2021 Grand Concourse
Bronx, NY 10453-4304 - Phone
- (718) 960-0310
- NPI assigned
- Jan 31, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 064839 | NY | Primary |
Addresses
Primary practice location
2021 Grand Concourse
Bronx, NY 10453-4304
Mailing address
2875 Sedgewick Ave
Bronx, NY 10463
Phone (347) 275-9074
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 064839 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Barnabas Hospital | Past | Accepting new patients | |
| St. Barnabas Hospital | Past | Accepting new patients | |
| Marvin Behavioral Health Ma PC | Clinical | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Bronx, NY
- NPI 1548367873
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376680835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2875 SEDGEWICK AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "10463",
"telephone_number": "347-275-9074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2021 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104534304",
"telephone_number": "718-960-0310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTONIO",
"first_name": "ELIZABETH",
"credential": "CLINICAL SOCIAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "064839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.