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NPI 1598307779

NPI 1598307779 : EMILY PEREDNIA LMSW : SAYVILLE, NY

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General NPI Number Information
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    NPI Number           |    1598307779
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    Entity Type          |    Individual 
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    Provider Name        |    EMILY PEREDNIA LMSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/09/2019
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    Last Update Date     |    10/09/2019
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Provider Practice Location Address
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    Address Line         |    296 N MAIN ST 
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    City                 |    SAYVILLE
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    State                |    NY
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    Zip                  |    11782-2550
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    Country              |    US
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    Telephone            |    631-472-2629
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    36 RIVERSIDE AVE 
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    City                 |    AMITYVILLE
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    State                |    NY
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    Zip                  |    11701-3733
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    Country              |    US
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    Telephone            |    516-680-8719
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    1074584
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    License Number State |    NY
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