1124150586 NPI number — MRS. ARLENE F REITZEL WILLIAMS CLINCAL SOCIAL WORKE

Table of content: MRS. ARLENE F REITZEL WILLIAMS CLINCAL SOCIAL WORKE (NPI 1124150586)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124150586 NPI number — MRS. ARLENE F REITZEL WILLIAMS CLINCAL SOCIAL WORKE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REITZEL WILLIAMS
Provider First Name:
ARLENE
Provider Middle Name:
F
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CLINCAL SOCIAL WORKE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
REITZEL WILLIAMS
Provider Other First Name:
ARLENE
Provider Other Middle Name:
F
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
CLINICAL SOCIAL WORK
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1124150586
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:
38 PUTNAM AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PATCHOGUE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11772-1098
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-758-7209
Provider Business Mailing Address Fax Number:
631-758-7209

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
38 PUTNAM AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PATCHOGUE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11772-1098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-758-7209
Provider Business Practice Location Address Fax Number:
631-758-7209
Provider Enumeration Date:
03/12/2007

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: 1041C0700X , with the licence number:  R041699-1 , 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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