MEDICARE: SUZANNE D'ADDONA LMSW

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
1	104100000X	Social Worker	109818-01	NY

General Provider Information

NPI Number	:	1679448054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE D'ADDONA LMSW

Provider Business Mailing Address
First Line	:	19 IRENE LN
Second Line	:
City	:	COMMACK
State	:	NY
Zip	:	11725-3913
Country	:	US
Telephone Number	:	631-774-3857
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 MARINERS WAY
Second Line	:
City	:	PORT JEFFERSON
State	:	NY
Zip	:	11777-1848
Country	:	US
Telephone Number	:	631-774-3857
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2025
Last Update Date	:	10/07/2025

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