Provider Demographics
NPI:1801463476
Name:ARGUETA MACHADO, ANA YANCI
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:YANCI
Last Name:ARGUETA MACHADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BELDON LN
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-4314
Mailing Address - Country:US
Mailing Address - Phone:631-645-8071
Mailing Address - Fax:
Practice Address - Street 1:185 OVAL DR
Practice Address - Street 2:
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749-1402
Practice Address - Country:US
Practice Address - Phone:631-645-8071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
NY114820-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program