1356330120 NPI number — MRS. ANGELA D MAHLER-ROMEO LMSW CSW

Table of content: MRS. ANGELA D MAHLER-ROMEO LMSW CSW (NPI 1356330120)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356330120 NPI number — MRS. ANGELA D MAHLER-ROMEO LMSW CSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAHLER-ROMEO
Provider First Name:
ANGELA
Provider Middle Name:
D
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMSW CSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MAHLER
Provider Other First Name:
ANGELA
Provider Other Middle Name:
D
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356330120
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 N OCEANSIDE RD
Provider Second Line Business Mailing Address:
ANGELA D MAHLER ROMEO
Provider Business Mailing Address City Name:
ROCKVILLE CENTRE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11570-5122
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-678-6641
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2277 GRAND AVE
Provider Second Line Business Practice Location Address:
SOUTH NASSAU COMMUNITIES HOSPITAL MENTAL HEALTH COUNSEL
Provider Business Practice Location Address City Name:
BALDWIN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11510-3148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-546-1370
Provider Business Practice Location Address Fax Number:
516-546-1028
Provider Enumeration Date:
10/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  0614681 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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