Provider Demographics
NPI:1851784409
Name:MARIA MUSCENTE, LCSW, PC
Entity Type:Organization
Organization Name:MARIA MUSCENTE, LCSW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MUSCENTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:607-351-1562
Mailing Address - Street 1:20 SAUNDERS RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-9698
Mailing Address - Country:US
Mailing Address - Phone:607-351-1562
Mailing Address - Fax:
Practice Address - Street 1:20 SAUNDERS RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-9698
Practice Address - Country:US
Practice Address - Phone:607-351-1562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053368R252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1457451163OtherNPI