Individual provider Active NPI

Amanda Czajkowski

  • Social Worker
  • Commack, NY
National Provider Identifier
1679382147
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
124194 Issued in NY
Practice address
358 Veterans Memorial Hwy Ste 9
Commack, NY 11725-4326
Phone
(631) 682-2814
NPI assigned
Dec 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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 124194 NY Primary

Addresses

Primary practice location

358 Veterans Memorial Hwy Ste 9
Commack, NY 11725-4326

Mailing address

404 River Ave
Patchogue, NY 11772-3394
Phone (631) 682-2814

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

NPI Registry JSON

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1679382147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 RIVER AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723394",
            "telephone_number": "631-682-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 VETERANS MEMORIAL HWY STE 9",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254326",
            "telephone_number": "631-682-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZAJKOWSKI",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "124194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.