| Jacqueline Raffaele, Lcsw, Pc | |
|
82 Elberta Dr East Northport NY 11731-5707 | |
| (516) 330-1186 | |
| Not Available |
| Full Name | Jacqueline Raffaele, Lcsw, Pc |
|---|---|
| Speciality | Social Worker |
| Location | 82 Elberta Dr, East Northport, New York |
| Authorized Official Name and Position | Jacqueline Raffaele (LCSW) |
| Authorized Official Contact | 5163301186 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqueline Raffaele, Lcsw, Pc 82 Elberta Dr East Northport NY 11731-5707 Ph: (516) 330-1186 | Jacqueline Raffaele, Lcsw, Pc 82 Elberta Dr East Northport NY 11731-5707 Ph: (516) 330-1186 |
| NPI Number | 1104663939 |
|---|---|
| Provider Enumeration Date | 07/10/2024 |
| Last Update Date | 07/10/2024 |
| Certification Date | 07/10/2024 |
| Medicare PECOS PAC ID | 4486187846 |
|---|---|
| Medicare Enrollment ID | O20241024001445 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104663939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jacqueline Raffaele |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396009189 PECOS PAC ID: 2961736806 Enrollment ID: I20190626000880 |
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