Active NPI
Marissa Gentile
- Social Worker
- Freeport, NY
National Provider Identifier
1649660515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 092991
- Practice address
- 333 N Main St
Freeport, NY 11520-1231 - Phone
- (516) 623-3322
- Fax
- (516) 623-3526
- NPI assigned
- Jan 30, 2015
- Last updated
- Jan 30, 2015
- Sex
- Female
- 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 | 092991 | NY | Primary |
Addresses
Primary practice location
333 N Main St
Freeport, NY 11520-1231
Mailing address
1331 Concord PL
Merrick, NY 11566-1538
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 092991 | Other | NY | LICENSE |
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 |
|---|---|---|---|
| 092991 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422576000000",
"number": "1649660515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1331 CONCORD PL",
"city": "MERRICK",
"state": "NY",
"postal_code": "115661538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 N MAIN ST",
"city": "FREEPORT",
"state": "NY",
"postal_code": "115201231",
"telephone_number": "516-623-3322",
"fax_number": "516-623-3526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTILE",
"first_name": "MARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-30",
"last_updated": "2015-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "092991",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "092991",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Freeport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.