MEDICARE: MRS. MARIA KEATING-PADBERG 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	R046906-1	NY

General Provider Information

NPI Number	:	1558471581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA KEATING-PADBERG LCSW

Provider Business Mailing Address
First Line	:	6 NORTHRIDGE CIR
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-5366
Country	:	US
Telephone Number	:	631-367-1933
Fax Number	:

Provider Business Practice Location Address
First Line	:	368 VETERANS MEMORIAL HWY STE 1
Second Line	:
City	:	COMMACK
State	:	NY
Zip	:	11725-4322
Country	:	US
Telephone Number	:	631-889-9174
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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