Aviva E Sala, LCSW

Individual provider Active NPI Clinical Social Worker · Old Bethpage, NY

NPI 1508915158 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1508915158
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
R051415 (NY)
Practice address
44 Simpson Dr
Old Bethpage, NY 11804-1220
Phone
(516) 293-4060
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R051415NYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R051415 NY Yes

Addresses

Primary practice location

44 Simpson Dr
Old Bethpage, NY 11804-1220

Mailing address

44 Simpson Dr
Old Bethpage, NY 11804-1220
Phone (516) 293-4060

Other identifiers

IdentifierTypeStateIssuer
460598OtherNYVALUE OPTIONS PROVIDER ID

Other providers in Old Bethpage, NY

All providers in Old Bethpage, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.