Provider Demographics
NPI:1821372905
Name:GAZITANO, WILLIAM STEPHEN (MSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:STEPHEN
Last Name:GAZITANO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 COURT ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-4233
Mailing Address - Country:US
Mailing Address - Phone:315-733-1726
Mailing Address - Fax:315-733-1789
Practice Address - Street 1:502 COURT ST
Practice Address - Street 2:SUITE 401
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4233
Practice Address - Country:US
Practice Address - Phone:315-733-1726
Practice Address - Fax:315-733-1789
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO19279-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical