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General NPI Number Information
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NPI Number | 1326079856
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Entity Type | Organization
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Legal Business Name | LAURA E ASNER CSW PC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 260 MONTAUK HWY STE-8
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City | BAY SHORE
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State | NY
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Zip | 11706
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Country | US
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Telephone | 631-647-9009
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Fax |
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Provider Business Mailing Address
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Address Line | 260 MONTAUK HWY STE-8
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City | BAY SHORE
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State | NY
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Zip | 11706
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Country | US
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Telephone | 631-647-9009
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MISS LAURA ASNER
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Credential | LCSW -R
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Telephone | 631-724-1513
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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 | R050228
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License Number State | NY
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