MEDICARE: THOMAS CURCIO 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
1	1041C0700X	Clinical Social Worker	030817	NY

General Provider Information

NPI Number	:	1245415439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS CURCIO LCSW

Provider Business Mailing Address
First Line	:	9 N MAIN ST
Second Line	:
City	:	EAST HAMPTON
State	:	NY
Zip	:	11937-2632
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 N MAIN ST
Second Line	:
City	:	EAST HAMPTON
State	:	NY
Zip	:	11937-2632
Country	:	US
Telephone Number	:	631-329-3092
Fax Number	:	631-329-3092

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2008
Last Update Date	:	01/07/2008

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