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NPI Code Detail

MEDICARE: PATRICIA ANTONUCCI

MEDICARE: PATRICIA ANTONUCCI
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 Worker093571-1NY

General Provider Information

NPI Number : 1225402365
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA ANTONUCCI
Provider Business Mailing Address
First Line : 285 LIVINGSTON ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11217-1006
Country : US
Telephone Number : 718-935-9201
Fax Number :
Provider Business Practice Location Address
First Line : 285 LIVINGSTON ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11217-1006
Country : US
Telephone Number : 718-935-9201
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2015
Last Update Date : 11/29/2015

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Directions to “ PATRICIA ANTONUCCI ” Practice Location

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