Healthcare Provider Details

I. General information

NPI: 1841369964
Provider Name (Legal Business Name): MARIAN KASKEL RCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 S OYSTER BAY RD
BETHPAGE NY
11714-1030
US

IV. Provider business mailing address

10 SUNCREST DR
DIX HILLS NY
11746-5733
US

V. Phone/Fax

Practice location:
  • Phone: 516-822-0622
  • Fax: 516-342-2480
Mailing address:
  • Phone: 516-822-0622
  • Fax: 516-342-2480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5298050
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: