Provider Demographics
NPI:1205197001
Name:SZCZECINA, JOHN J (MSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:SZCZECINA
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CENTER DR
Mailing Address - Street 2:ROOM 206N
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-3393
Mailing Address - Country:US
Mailing Address - Phone:631-852-1404
Mailing Address - Fax:631-852-2688
Practice Address - Street 1:300 CENTER DR
Practice Address - Street 2:ROOM 206N
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-3393
Practice Address - Country:US
Practice Address - Phone:631-852-1404
Practice Address - Fax:631-852-2688
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator