Provider Demographics
NPI:1497308985
Name:HOROWITZ, CRISTINE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CRISTINE
Middle Name:
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CRISTINE
Other - Middle Name:
Other - Last Name:PARMIGIANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:320 CARLETON AVE
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-4506
Mailing Address - Country:US
Mailing Address - Phone:631-663-4300
Mailing Address - Fax:631-439-4066
Practice Address - Street 1:208 ROANOKE AVE
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2706
Practice Address - Country:US
Practice Address - Phone:631-998-0003
Practice Address - Fax:631-284-2541
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-23
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY089445104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1497308985Medicaid