Antczak, Elisse Marie
Antczak, Elisse Marie is an sole proprietor health care provider with primary practice located at 3960 Harlem Rd Ste 10 , Snyder NY 14226-4706. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Antczak, Elisse Marie can be contacted via phone (716) 238-0829.Contact Information
Primary practice address
3960 Harlem Rd Ste 10
Snyder NY 14226-4706
Phone: (716) 238-0829
Fax: (716) 898-8802
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | R048061-01 | New York |
Profile Details
| NPI number | 1316008352 |
|---|---|
| LBN Legal business name | Antczak, Elisse Marie |
| Credentials | LCSWR |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 13th, 2006 |
| Last updated | Sep 7th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316008352 | NPPES |
| New York | Other | 6211545 | INDEPENDENT HEALTH |
| New York | Other | 00026849603 | INDEPENDENT HEALTH |
| New York | Other | 000526673002 | INDEPENDENT HEALTH |
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