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General NPI Number Information
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NPI Number | 1164967188
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Entity Type | Organization
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Legal Business Name | DIANA GASPERONI LCSW PLLC
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Dates
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Enumeration Date | 12/29/2016
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 928 BROADWAY SUITE 1206
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City | NEW YORK
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State | NY
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Zip | 10010-6008
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Country | US
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Telephone | 646-898-9460
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Fax |
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Provider Business Mailing Address
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Address Line | 928 BROADWAY SUITE 1206
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City | NEW YORK
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State | NY
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Zip | 10010-6008
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Country | US
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Telephone | 646-898-9460
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MS. DIANA M GASPERONI
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Credential | LCSW R
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Telephone | 646-863-0101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 078196
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License Number State | NY
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