Provider Demographics
NPI:1780730622
Name:D'AMATO, ERNEST (CSW)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:
Last Name:D'AMATO
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6735 RIDGE BLVD
Mailing Address - Street 2:SUITE 6G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5248
Mailing Address - Country:US
Mailing Address - Phone:718-836-9281
Mailing Address - Fax:
Practice Address - Street 1:6735 RIDGE BLVD
Practice Address - Street 2:SUITE 6G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5248
Practice Address - Country:US
Practice Address - Phone:718-836-9281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR014068-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY107515OtherMANAGED HEALTH NETWORK
NY1780730622OtherCIGNA
NY109567OtherVALUE OPTIONS
NYN90222OtherEBCBS
NY0088215OtherG.H.I.
NY141488000OtherAETNA MAGELLAN
NY1780730622OtherCIGNA