=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417812405
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MIA L RASPANTI
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2025
-----------------------------------------------------
Last Update Date | 12/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 W NICHOLAI ST UNIT 2
-----------------------------------------------------
City | HICKSVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11801-3887
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-818-9901
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 52 PROSPECT RD
-----------------------------------------------------
City | CENTERPORT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11721-1130
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-819-5874
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 128705-01
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------