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NPI Code Detail

MEDICARE: MS. ROSEMARY ALICE MARCACCIO LCSW

MEDICARE: MS. ROSEMARY ALICE MARCACCIO 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 WorkerR056937-1NY

General Provider Information

NPI Number : 1659576270
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ROSEMARY ALICE MARCACCIO LCSW
Provider Business Mailing Address
First Line : 843 OUTLOOK AVE
Second Line :
City : WEST BABYLON
State : NY
Zip : 11704-4420
Country : US
Telephone Number : 516-582-6424
Fax Number : 631-261-3503
Provider Business Practice Location Address
First Line : 410 E MAIN ST
Second Line :
City : CENTERPORT
State : NY
Zip : 11721-1541
Country : US
Telephone Number : 631-261-3503
Fax Number : 631-261-3503
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2007
Last Update Date : 07/08/2007

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Directions to “ MS. ROSEMARY ALICE MARCACCIO LCSW” Practice Location

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