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General NPI Number Information
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NPI Number | 1629164660
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Entity Type | Individual
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Provider Name | MARIA F DUPERVAL LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 11/02/2015
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Provider Practice Location Address
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Address Line | 165 N VILLAGE AVE STE 114A
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-3701
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Country | US
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Telephone | 516-455-1551
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Fax |
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Provider Business Mailing Address
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Address Line | 165 N VILLAGE AVE STE 114A
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-3701
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Country | US
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Telephone | 516-455-1551
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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 | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 074335-1
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License Number State | NY
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