Mandra Stallone, Gail I

Mandra Stallone, Gail I is an sole proprietor health care provider with primary practice located at 445 Broadhollow Rd Suite 228, Melville NY 11747-3669. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Mandra Stallone, Gail I can be contacted via phone (631) 827-8200.

Contact Information

Primary practice address
445 Broadhollow Rd Suite 228 Melville NY 11747-3669
Fax: (631) 501-1103
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 053058-1 New York

Profile Details

NPI number 1124132832
LBN Legal business name Mandra Stallone, Gail I
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 18th, 2006
Last updated Dec 1st, 2016 - about 8 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 1124132832 NPPES
New York Other A300062673 MEDICARE PTAN
New York MEDICAID 0039339 MEDICARE PTAN

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