Chiesa, Myrna M
Chiesa, Myrna M is an sole proprietor health care provider with primary practice located at 485 Easton St , Ronkonkoma NY 11779-6154. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Chiesa, Myrna M can be contacted via phone (631) 585-7858.Contact Information
Primary practice address
485 Easton St
Ronkonkoma NY 11779-6154
Phone: (631) 585-7858
Fax: (631) 585-7858
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | R30964-1 | New York |
Profile Details
| NPI number | 1831254200 |
|---|---|
| LBN Legal business name | Chiesa, Myrna M |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 26th, 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 | 1831254200 | NPPES |
| New York | MEDICAID | 02026355 |
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