Provider Demographics
NPI:1003831694
Name:RAIMONDO, FRANK ARTHUR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:ARTHUR
Last Name:RAIMONDO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BURCHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-3158
Mailing Address - Country:US
Mailing Address - Phone:908-276-3826
Mailing Address - Fax:
Practice Address - Street 1:290 GARRETSON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1236
Practice Address - Country:US
Practice Address - Phone:718-698-3222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR044406-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNOB771Medicare ID - Type Unspecified
NYNOB772Medicare ID - Type Unspecified