Provider Demographics
NPI:1942299680
Name:PLESENT, EMANUEL (MSW)
Entity Type:Individual
Prefix:MR
First Name:EMANUEL
Middle Name:
Last Name:PLESENT
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 1:32 BUTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4805
Mailing Address - Country:US
Mailing Address - Phone:613-499-0977
Mailing Address - Fax:
Practice Address - Street 1:101 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-2347
Practice Address - Country:US
Practice Address - Phone:516-747-1344
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23305-R--LCSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNO8131Medicare ID - Type Unspecified