Most Relevant Information
Provider Data
| NPI Number: | 1003244476 |
| Provider Name: | AMY ANTONIAZZI LCSW-R |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | R040238 |
Most Important Dates
| Enumeration Date: | 10/23/2013 |
| Last Updated: | 10/23/2013 |
Provider Practice Location
1709 MICHAEL WILLIAM RD
MERRICK
NY
115662523
Practice Location Phone/Fax
| Phone: | 5163783115 |
| Fax: |
Provider Mailing Location
1709 MICHAEL WILLIAM RD
MERRICK
NY
115662523
Provider Mailing Phone/Fax
| Phone: | 5163783115 |
| Fax: |