Most Relevant Information
Provider Data
| NPI Number: | 1003567025 |
| Provider Name: | JESSICA PANAGIOTIDIS LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 114681 |
Most Important Dates
| Enumeration Date: | 01/11/2022 |
| Last Updated: | 01/11/2022 |
Provider Practice Location
521 ROUTE 111 STE 202
HAUPPAUGE
NY
117884358
Practice Location Phone/Fax
| Phone: | 6312659850 |
| Fax: |
Provider Mailing Location
PO BOX 530
E NORTHPORT
NY
117310475
Provider Mailing Phone/Fax
| Phone: | 6312659850 |
| Fax: | 6315219852 |