Individual provider Active NPI

Carol A Dandrea

  • Social Worker
  • Little Neck, NY
National Provider Identifier
1972673754
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
R0419771 Issued in NY
Practice address
25504 58 Avenue
Little Neck, NY 11362-2149
Phone
(718) 224-2253
Fax
(718) 224-2253
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

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
Social Worker 104100000X R0419771 NY Primary

Addresses

Primary practice location

25504 58 Avenue
Little Neck, NY 11362-2149

Mailing address

25504 58 Avenue
Little Neck, NY 11362-2149
Phone (718) 224-2253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151222000674 NY Practitioner - Clinical Social Worker 3971804600 Practice locations: Little Neck, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

25504 58 Ave
Little Neck, NY 11362-2149

25504 58TH Ave
Little Neck, NY 11362-2149
Phone (718) 224-2253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
R0419771NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972673754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25504 58 AVENUE",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113622149",
            "telephone_number": "718-224-2253",
            "fax_number": "718-224-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25504 58 AVENUE",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113622149",
            "telephone_number": "718-224-2253",
            "fax_number": "718-224-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDREA",
        "first_name": "CAROL",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "R0419771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Neck, NY

Sources for this page

Verify at the official NPI Registry.