Individual provider Active NPI

Mark Dworkin

  • Clinical Social Worker
  • East Meadow, NY
National Provider Identifier
1649314014
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR024359-1 Issued in NY
Practice address
251 Mercury St
East Meadow, NY 11554-1222
Phone
(516) 731-7611
Fax
(516) 579-0171
NPI assigned
Feb 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X PR024359-1 NY Primary

Addresses

Primary practice location

251 Mercury St
East Meadow, NY 11554-1222

Mailing address

251 Mercury St
East Meadow, NY 11554-1222
Phone (516) 731-7611

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

LicenseStateTypeSpecialty
PR024359-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649314014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 MERCURY ST",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541222",
            "telephone_number": "516-731-7611",
            "fax_number": "516-579-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 MERCURY ST",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541222",
            "telephone_number": "516-731-7611",
            "fax_number": "516-579-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWORKIN",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR024359-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, 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.

Verify at the official NPI Registry.