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General NPI Number Information
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NPI Number | 1184633588
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Entity Type | Individual
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Provider Name | EDWARD M. BACIGALUPO LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 08/09/2013
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Provider Practice Location Address
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Address Line | 275 NORTH ST SUITE G514
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City | HARRISON
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State | NY
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Zip | 10528-1140
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Country | US
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Telephone | 917-886-5284
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Fax |
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Provider Business Mailing Address
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Address Line | 6 GLENVILLE RD
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City | NEW FAIRFIELD
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State | CT
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Zip | 06812-3737
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Country | US
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Telephone | 917-886-5284
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 007257
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 076976
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License Number State | NY
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