Provider Demographics
NPI:1649652611
Name:BUONAGURA, CRISTA ANN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:CRISTA
Middle Name:ANN
Last Name:BUONAGURA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:CRISTA
Other - Middle Name:ANN
Other - Last Name:ADDUCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1500 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1551
Mailing Address - Country:US
Mailing Address - Phone:516-739-7733
Mailing Address - Fax:
Practice Address - Street 1:1500 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1551
Practice Address - Country:US
Practice Address - Phone:516-739-7733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker