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NPI Code Detail

MEDICARE: MS. CONSTANCE ANN GULINO LCSWR, CASAC

MEDICARE: MS. CONSTANCE ANN GULINO LCSWR, CASAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerR0426201NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000250811010OTHERNYUNIVERA BEHAVIORAL HEALTH
2000525494001OTHERNYBLUE CROSS AND BLUE SHIEL
362126787OTHERNYINDEPENDENT HEALTH
410768073OTHERNYCAQH

General Provider Information

NPI Number : 1558469346
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CONSTANCE ANN GULINO LCSWR, CASAC
Provider Business Mailing Address
First Line : 4608 KENNISON PKWY
Second Line :
City : HAMBURG
State : NY
Zip : 14075-3117
Country : US
Telephone Number : 716-228-1329
Fax Number : 716-648-2760
Provider Business Practice Location Address
First Line : 162 MAIN ST
Second Line :
City : HAMBURG
State : NY
Zip : 14075-4917
Country : US
Telephone Number : 716-228-1329
Fax Number : 716-648-2760
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/08/2007

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