Damico, Judith

Damico, Judith is an sole proprietor health care provider with primary practice located at 903 Main St Suite 202, Port Jefferson NY 11777-2262. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Damico, Judith can be contacted via phone (631) 473-3060.

Contact Information

Primary practice address
903 Main St Suite 202 Port Jefferson NY 11777-2262
Phone: (631) 473-3060
Fax: (631) 751-2850
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X LCSW R016472-1 New York

Profile Details

NPI number 1396842944
LBN Legal business name Damico, Judith
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 17th, 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 1396842944 NPPES
Other 74009640 GHI, EMPIRE PLAN
Other N61882 GHI, EMPIRE PLAN
Other 059761 GHI, EMPIRE PLAN
Other P1533264 GHI, EMPIRE PLAN
Other 02027003 GHI, EMPIRE PLAN

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