Provider Demographics
NPI:1912874298
Name:ZANFARDINO, MADISON ROSE (LMSW)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:ROSE
Last Name:ZANFARDINO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16241 POWELLS COVE BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1449
Mailing Address - Country:US
Mailing Address - Phone:646-402-3203
Mailing Address - Fax:
Practice Address - Street 1:27 CEDAR SWAMP RD
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-4425
Practice Address - Country:US
Practice Address - Phone:516-801-6915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128482-011041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool