Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 072286 | NY |
NPI | 1003012071 |
---|---|
Provider Name | Ms. Ann Marie Gargiulo |
First Address | Bronx, NY 10460-1028 |
Second Address | Bronx, NY 10458-5871 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2007 |
Last Update Date | 08/07/2007 |