Individual provider Active NPI

Christina Marie Anello

  • Social Worker
  • Jericho, NY
National Provider Identifier
1508647850
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
121602 Issued in NY
Practice address
350 Jericho Tpke Ste 103
Jericho, NY 11753-1317
Phone
(631) 828-9871
NPI assigned
Oct 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 121602 NY Primary

Addresses

Primary practice location

350 Jericho Tpke Ste 103
Jericho, NY 11753-1317

Mailing address

6 Tarn CT
Deer Park, NY 11729-6222
Phone (631) 494-8950

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
121602NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1508647850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 TARN CT",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117296222",
            "telephone_number": "631-494-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 JERICHO TPKE STE 103",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531317",
            "telephone_number": "631-828-9871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANELLO",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "121602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jericho, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.