Provider Demographics
NPI:1346526894
Name:SAVARESE, RONALD LOUIS
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:LOUIS
Last Name:SAVARESE
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:RONALD
Other - Middle Name:
Other - Last Name:SAVARESE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW/PHD
Mailing Address - Street 1:45 N STATION PLZ
Mailing Address - Street 2:SUITE 310
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5033
Mailing Address - Country:US
Mailing Address - Phone:516-482-0119
Mailing Address - Fax:
Practice Address - Street 1:45 N STATION PLZ
Practice Address - Street 2:SUITE 310
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5033
Practice Address - Country:US
Practice Address - Phone:516-482-0119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR023460-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical