Provider Demographics
NPI:1356433056
Name:CRESCENZO, ANTHONY M SR (LCSW)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:M
Last Name:CRESCENZO
Suffix:SR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 DALMENY ROAD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510
Mailing Address - Country:US
Mailing Address - Phone:914-762-2794
Mailing Address - Fax:
Practice Address - Street 1:44 WESTCHESTER SQUARE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-409-1047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR01188911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0093057OtherGHI
NYN04681Medicare ID - Type Unspecified