Healthcare Provider Details

I. General information

NPI: 1356330120
Provider Name (Legal Business Name): ANGELA D MAHLER-ROMEO LMSW CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: ANGELA D MAHLER

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2277 GRAND AVE SOUTH NASSAU COMMUNITIES HOSPITAL MENTAL HEALTH COUNSEL
BALDWIN NY
11510-3148
US

IV. Provider business mailing address

20 N OCEANSIDE RD ANGELA D MAHLER ROMEO
ROCKVILLE CENTRE NY
11570-5122
US

V. Phone/Fax

Practice location:
  • Phone: 516-546-1370
  • Fax: 516-546-1028
Mailing address:
  • Phone: 516-678-6641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0614681
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: