Provider Demographics
NPI:1316683998
Name:COTRONE, EMILY MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:COTRONE
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 1:16 INGELORE CT
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-1706
Mailing Address - Country:US
Mailing Address - Phone:516-672-2598
Mailing Address - Fax:
Practice Address - Street 1:811 W JERICHO TPKE STE 106E
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3220
Practice Address - Country:US
Practice Address - Phone:631-306-4284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-07
Last Update Date:2022-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1160421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY117M96306OtherEMPIRE BLUECROSS BLUESHIELD