Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 082827 | NY |
NPI | 1003192501 |
---|---|
Provider Name | Keri Marie Pinelli |
First Address | Northport, NY 11768-2200 |
Second Address | Northport, NY 11768-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2011 |
Last Update Date | 18/06/2014 |