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NPI 1407327349

NPI 1407327349 : NICOLE DINA NAGGAR LCSW : COLD SPRING HARBOR, NY

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General NPI Number Information
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    NPI Number           |    1407327349
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    Entity Type          |    Individual 
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    Provider Name        |    NICOLE DINA NAGGAR LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/17/2018
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    Last Update Date     |    12/17/2018
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Provider Practice Location Address
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    Address Line         |    147 MAIN ST 
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    City                 |    COLD SPRING HARBOR
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    State                |    NY
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    Zip                  |    11724-1425
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    Country              |    US
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    Telephone            |    631-606-0381
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    Fax                  |    631-824-9000
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Provider Business Mailing Address
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    Address Line         |    5 INDEPENDENCE PL 
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    City                 |    HUNTINGTON STATION
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    State                |    NY
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    Zip                  |    11746-4316
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    Country              |    US
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    Telephone            |    631-606-0381
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    Fax                  |    631-824-9000
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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       |    R070453-1
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    License Number State |    NY
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