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
Fax: (631) 585-7858
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831254200 NPPES
New York MEDICAID 02026355

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