Healthcare Provider Details

I. General information

NPI: 1497239685
Provider Name (Legal Business Name): EMMA PICCIANO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2018
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 MAIN ST
BINGHAMTON NY
13905-2522
US

IV. Provider business mailing address

2570 ROUTE 9W STE 10
CORNWALL NY
12518-1370
US

V. Phone/Fax

Practice location:
  • Phone: 607-729-6206
  • Fax:
Mailing address:
  • Phone: 845-220-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number093077
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: