Provider Demographics
NPI:1154733921
Name:ASSIF, LAUREL (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:ASSIF
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 CLEARMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1217
Mailing Address - Country:US
Mailing Address - Phone:516-650-4141
Mailing Address - Fax:
Practice Address - Street 1:484 CLEARMEADOW DR
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1217
Practice Address - Country:US
Practice Address - Phone:516-650-4141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053310104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker