Antz, Philip Joachim
Antz, Philip Joachim is an sole proprietor health care provider with primary practice located at 470 Starlight Dr , Shirley NY 11967-1221. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Antz, Philip Joachim can be contacted via phone (631) 345-6310.Contact Information
Primary practice address
470 Starlight Dr
Shirley NY 11967-1221
Phone: (631) 345-6310
Fax: (631) 775-6601
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | R-040389-1 | New York |
Profile Details
| NPI number | 1134290521 |
|---|---|
| LBN Legal business name | Antz, Philip Joachim |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 10th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1134290521 | NPPES |
| New York | MEDICAID | 020831549 |
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