Joseph, Anthony Nicodemus

Joseph, Anthony Nicodemus is an individual health care provider with primary practice located at 1055 Pinebrook Blvd , New Rochelle NY 10804-1827. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Joseph, Anthony Nicodemus can be contacted via phone (646) 294-3696.

Contact Information

Primary practice address
1055 Pinebrook Blvd New Rochelle NY 10804-1827
Phone: (646) 294-3696
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 84343 New York

Profile Details

NPI number 1609122704
LBN Legal business name Joseph, Anthony Nicodemus
Credentials MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2012
Last updated Jul 26th, 2012 - about 14 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 1609122704 NPPES
New York MEDICAID XXXXXXXXXX

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