Mark Dimartino, LCSW | |
79 Glenridge Rd, Glenville, NY 12302-4523 | |
(518) 952-8335 | |
Not Available |
Full Name | Mark Dimartino |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 79 Glenridge Rd, Glenville, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598787095 | NPI | - | NPPES |
01420800 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 026080 (New York) | Primary |
Entity Name | Conifer Park Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356396543 PECOS PAC ID: 2769470384 Enrollment ID: O20040503001584 |
Mailing Address | Practice Location Address |
---|---|
Mark Dimartino, LCSW 79 Glenridge Rd, Glenville, NY 12302-4523 Ph: () - | Mark Dimartino, LCSW 79 Glenridge Rd, Glenville, NY 12302-4523 Ph: (518) 952-8335 |
Christine Lemp, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1036 Tomahawk Trl, Glenville, NY 12302 Phone: 518-390-8918 | |
Ms. Ellen Bressler Wakesberg, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 113 Saratoga Rd, Glenville, NY 12302 Phone: 518-399-0637 Fax: 518-399-7195 | |
Michele Kathleen Frasca, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 50 Cypress Dr, Glenville, NY 12302 Phone: 518-399-9141 | |
Mr. Martin Wakesberg, MSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 113 Saratoga Rd, Glenville, NY 12302 Phone: 518-399-0637 Fax: 518-399-7195 | |
Ciara Diemer, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6 Montclair Dr, Glenville, NY 12302 Phone: 518-866-9289 | |
Alyssa Lupinski, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 131 Wyatts Dr, Glenville, NY 12302 Phone: 315-794-1382 |