Healthcare Provider Details

I. General information

NPI: 1184784217
Provider Name (Legal Business Name): EILEEN TOONE CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 09/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 JERUSALEM AVE STE 107
N BELLMORE NY
11710
US

IV. Provider business mailing address

1109 BELLMORE AVE
N BELLMORE NY
11710-5545
US

V. Phone/Fax

Practice location:
  • Phone: 516-873-1288
  • Fax: 516-308-4586
Mailing address:
  • Phone: 516-804-5131
  • Fax: 516-398-4586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberR0338391
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: