Provider Demographics
NPI:1821213646
Name:PRINO, MONICA ESTHER (MSW)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:ESTHER
Last Name:PRINO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-4516
Mailing Address - Country:US
Mailing Address - Phone:631-427-3700
Mailing Address - Fax:631-427-4268
Practice Address - Street 1:1490 WILLIAM FLOYD PKWY
Practice Address - Street 2:
Practice Address - City:EAST YAPHANK
Practice Address - State:NY
Practice Address - Zip Code:11967-1820
Practice Address - Country:US
Practice Address - Phone:631-927-3741
Practice Address - Fax:631-924-2413
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPENDING104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker