Provider Demographics
NPI:1396177432
Name:GADALETA, NINA DELLAFERA (LCSW)
Entity type:Individual
Prefix:MS
First Name:NINA
Middle Name:DELLAFERA
Last Name:GADALETA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
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Mailing Address - Street 1:25 OLD PINE DR
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2009
Mailing Address - Country:US
Mailing Address - Phone:516-532-2828
Mailing Address - Fax:516-365-0532
Practice Address - Street 1:585 PLANDOME RD
Practice Address - Street 2:SUITE 106
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-1968
Practice Address - Country:US
Practice Address - Phone:516-405-3698
Practice Address - Fax:516-365-0532
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078667-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400105898Medicare PIN
NYA300120771Medicare PIN