Provider Demographics
NPI:1144207085
Name:CARLOMAGNO, ALFRED (DSW)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:
Last Name:CARLOMAGNO
Suffix:
Gender:M
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 414 BOX 1051
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09173-1051
Mailing Address - Country:US
Mailing Address - Phone:314-466-4625
Mailing Address - Fax:314-466-2065
Practice Address - Street 1:CMR 414 BOX 1051
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09173-1051
Practice Address - Country:US
Practice Address - Phone:314-466-4625
Practice Address - Fax:314-466-2065
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO163191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical