Provider Demographics
NPI:1629238399
Name:DIGIOVANNA, ROBERT NICHOLAS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:NICHOLAS
Last Name:DIGIOVANNA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:469 FRENCH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-2105
Mailing Address - Country:US
Mailing Address - Phone:631-595-2673
Mailing Address - Fax:631-595-2673
Practice Address - Street 1:2061 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-2120
Practice Address - Country:US
Practice Address - Phone:631-595-2673
Practice Address - Fax:631-595-2673
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-036500-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical