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NPI Code Detail

MEDICARE: MS. ANGELINA GRAZIOSI LCSW

MEDICARE: MS. ANGELINA GRAZIOSI LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker070346NY

General Provider Information

NPI Number : 1104005750
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANGELINA GRAZIOSI LCSW
Provider Business Mailing Address
First Line : 40 GLEN KEITH RD APT U
Second Line :
City : GLEN COVE
State : NY
Zip : 11542-3515
Country : US
Telephone Number : 516-659-6114
Fax Number :
Provider Business Practice Location Address
First Line : 57190 MAIN RD
Second Line :
City : SOUTHOLD
State : NY
Zip : 11971-4750
Country : US
Telephone Number : 631-626-1006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2007
Last Update Date : 02/01/2021

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