Active NPI
Mark Pandolfi, LMSW
- Social Worker
- Center Moriches, NY
National Provider Identifier
1497096598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 040008-1
- Practice address
- 220 Main St
Center Moriches, NY 11934-3516 - Phone
- (631) 874-2700
- NPI assigned
- Mar 14, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 040008-1 | NY | Primary |
Addresses
Primary practice location
220 Main St
Center Moriches, NY 11934-3516
Mailing address
790 Park Avenue
Huntington, NY 11790
Phone (631) 427-3700
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
| License | State | Type | Specialty |
|---|---|---|---|
| 040008-1 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363219200000",
"number": "1497096598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 PARK AVENUE",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "11790",
"telephone_number": "631-427-3700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 MAIN ST",
"city": "CENTER MORICHES",
"state": "NY",
"postal_code": "119343516",
"telephone_number": "631-874-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANDOLFI",
"first_name": "MARK",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-03-14",
"last_updated": "2013-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "040008-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Center Moriches, NY
- Oasis Rehabilitation and Nursing LLC
- Stefanie Ortiz
- Laura Otton
- Out East Therapy of New York for OT, PT, SLP, RN and Psychology Servic
- Out East Therapy of New York for OT, PT, SLP, RN and Psychology Servic
- Cynthia Lyn Pantol, MASTERS
- Kerry Christine Paras, PH.D.
- Linda Ann Pelosi, R-LCSW
- Gregory Petrucci
- Physical Medicine of Suffolk, LLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.