Provider Demographics
NPI:1912550542
Name:ALBERTARIO, CLAUDE LAWRENCE (RPSGT, RST)
Entity Type:Individual
Prefix:
First Name:CLAUDE
Middle Name:LAWRENCE
Last Name:ALBERTARIO
Suffix:
Gender:M
Credentials:RPSGT, RST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3334 BAYFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-4622
Mailing Address - Country:US
Mailing Address - Phone:516-225-0421
Mailing Address - Fax:
Practice Address - Street 1:505 E 70TH ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4872
Practice Address - Country:US
Practice Address - Phone:646-962-9354
Practice Address - Fax:646-962-0246
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-23
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000147-1174400000X, 174H00000X, 246Z00000X, 2472E0500X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174400000XOther Service ProvidersSpecialist
No174H00000XOther Service ProvidersHealth Educator
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG