Provider Demographics
NPI:1588479299
Name:D'ANTONIO, VALERIE (SERVICE COORDINATOR)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:D'ANTONIO
Suffix:
Gender:F
Credentials:SERVICE COORDINATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-3915
Mailing Address - Country:US
Mailing Address - Phone:631-334-4334
Mailing Address - Fax:
Practice Address - Street 1:1227 MONTAUK HWY UNIT 2
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:NY
Practice Address - Zip Code:11769-1492
Practice Address - Country:US
Practice Address - Phone:631-218-1545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator