Healthcare Provider Details

I. General information

NPI: 1689219438
Provider Name (Legal Business Name): SHIRODKAR SOCIAL WORK SERVICES, LMSW, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2019
Last Update Date: 11/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 AUDREY AVE
PLAINVIEW NY
11803-3514
US

IV. Provider business mailing address

59 AUDREY AVE
PLAINVIEW NY
11803-3514
US

V. Phone/Fax

Practice location:
  • Phone: 516-661-5314
  • Fax: 516-935-4805
Mailing address:
  • Phone: 516-661-5314
  • Fax: 516-935-4805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. JENNIFER L SHIRODKAR
Title or Position: PRESIDENT
Credential: LMSW
Phone: 516-661-5314