Active NPI
Emma Rae Immediato, MSW
- Social Worker
- Jericho, NY
National Provider Identifier
1871331736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 095074
- Practice address
- 350 Jericho Tpke Ste 103
Jericho, NY 11753-1317 - Phone
- (516) 339-5373
- NPI assigned
- Jul 16, 2024
- 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 | 095074 | NY | Primary |
Addresses
Primary practice location
350 Jericho Tpke Ste 103
Jericho, NY 11753-1317
Mailing address
7 Agatha Dr
Plainview, NY 11803-5401
Phone (516) 729-3405
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 |
|---|---|---|---|
| 095074 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721088000000",
"number": "1871331736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 AGATHA DR",
"city": "PLAINVIEW",
"state": "NY",
"postal_code": "118035401",
"telephone_number": "516-729-3405"
},
{
"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": "516-339-5373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMMEDIATO",
"first_name": "EMMA",
"middle_name": "RAE",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-16",
"last_updated": "2024-07-16",
"certification_date": "2024-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "095074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jericho, NY
- Kerri Susan Herzog, SPEECH PATHOLOGIST
- Linda Hirsch, SLP
- Fredy Ho
- Holbrook Speech Services, Inc.
- Yanira Coralyn Ildefonso-Patino, MHC-LP
- Inspiration Group Inc
- Inspiration Group Inc
- Integrative Osteopathic Multispecialty Medical Associates, PLLC
- Barbara Ippolito, PH.D.
- Irina Levy Nurse Practitioner in Psychiatry P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.