| Antonio Okosky Lcsw Llc | |
|
400 Bayonet St Ste 202 New London CT 06320-2600 | |
| (860) 501-4110 | |
| Not Available |
| Full Name | Antonio Okosky Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 400 Bayonet St Ste 202, New London, Connecticut |
| Authorized Official Name and Position | Terri Fogg Donovan (OFFICE MANAGER) |
| Authorized Official Contact | 8605359922 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Antonio Okosky Lcsw Llc 240 S Anguilla Rd Pawcatuck CT 06379-1439 Ph: (860) 501-4110 | Antonio Okosky Lcsw Llc 400 Bayonet St Ste 202 New London CT 06320-2600 Ph: (860) 501-4110 |
| NPI Number | 1689399222 |
|---|---|
| Provider Enumeration Date | 10/06/2022 |
| Last Update Date | 10/06/2022 |
| Certification Date | 10/06/2022 |
| Medicare PECOS PAC ID | 2769850874 |
|---|---|
| Medicare Enrollment ID | O20221122000055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689399222 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Antonio Okosky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467199760 PECOS PAC ID: 9638558125 Enrollment ID: I20220613002532 |
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