MEDICARE: ELISA CARLINO

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	1041C0700X	Clinical Social Worker	075908-01	NY

General Provider Information

NPI Number	:	1770238347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISA CARLINO

Provider Business Mailing Address
First Line	:	9710 THE MAPLES
Second Line	:
City	:	CLARENCE
State	:	NY
Zip	:	14031-1594
Country	:	US
Telephone Number	:	716-400-6050
Fax Number	:

Provider Business Practice Location Address
First Line	:	9710 THE MAPLES
Second Line	:
City	:	CLARENCE
State	:	NY
Zip	:	14031-1594
Country	:	US
Telephone Number	:	716-400-6050
Fax Number	:

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

Provider Enumeration Date	:	02/12/2022
Last Update Date	:	02/12/2022

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Directions to “ ELISA CARLINO ” Practice Location

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