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
Phone: (631) 827-8200
Fax: (631) 501-1103
Website:
Health care specialties
| Specialty | Code | License # | 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 10 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 | 1124132832 | NPPES |
| New York | Other | A300062673 | MEDICARE PTAN |
| New York | MEDICAID | 0039339 | MEDICARE PTAN |
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