| Anthony Gaudioso, Ph.d, Licensed Mental Health Counselor, P.c. | |
|
695 Buck Rd Stone Ridge NY 12484-5500 | |
| (917) 470-9224 | |
| (917) 470-9330 |
| Full Name | Anthony Gaudioso, Ph.d, Licensed Mental Health Counselor, P.c. |
|---|---|
| Speciality | Counselor |
| Location | 695 Buck Rd, Stone Ridge, New York |
| Authorized Official Name and Position | Anthony Gaudioso (OWNER) |
| Authorized Official Contact | 2127291450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony Gaudioso, Ph.d, Licensed Mental Health Counselor, P.c. 695 Buck Rd Stone Ridge NY 12484-5500 Ph: (212) 729-1450 | Anthony Gaudioso, Ph.d, Licensed Mental Health Counselor, P.c. 695 Buck Rd Stone Ridge NY 12484-5500 Ph: (917) 470-9224 |
| NPI Number | 1376788604 |
|---|---|
| Provider Enumeration Date | 12/16/2008 |
| Last Update Date | 08/02/2022 |
| Certification Date | 08/02/2022 |
| Medicare PECOS PAC ID | 8123471034 |
|---|---|
| Medicare Enrollment ID | O20240126003005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376788604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 000464-1 (New York) | Primary |
| Provider Name | Anthony Onofrio Gaudioso |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083684096 PECOS PAC ID: 5799138699 Enrollment ID: I20240126002890 |
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