MEDICARE: MS. ROSEMARIE CARLONI 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	101YM0800X	Mental Health Counselor	R038937	NY

General Provider Information

NPI Number	:	1457334120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROSEMARIE CARLONI LCSW

Provider Business Mailing Address
First Line	:	679 48TH ST
Second Line	:	APT. 2L
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2153
Country	:	US
Telephone Number	:	718-871-3439
Fax Number	:

Provider Business Practice Location Address
First Line	:	443 BAY RIDGE PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-2701
Country	:	US
Telephone Number	:	917-435-0120
Fax Number	:

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

Provider Enumeration Date	:	11/27/2005
Last Update Date	:	07/08/2007

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