Provider Demographics
NPI:1497832596
Name:BISK, NAOMI J (LCSW CASAL)
Entity Type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:J
Last Name:BISK
Suffix:
Gender:F
Credentials:LCSW CASAL
Other - Prefix:MS
Other - First Name:NAOMI
Other - Middle Name:J
Other - Last Name:BOSGANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:175 SCARCLIFFE DR
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565
Mailing Address - Country:US
Mailing Address - Phone:516-837-8572
Mailing Address - Fax:516-837-8572
Practice Address - Street 1:80 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570
Practice Address - Country:US
Practice Address - Phone:516-316-0096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24087R104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker