| Ernest Leuci Lcsw Pc | |
|
3 Premier Ct Port Jefferson Station NY 11776-3198 | |
| (631) 476-7119 | |
| (631) 476-7119 |
| Full Name | Ernest Leuci Lcsw Pc |
|---|---|
| Speciality | Social Worker |
| Location | 3 Premier Ct, Port Jefferson Station, New York |
| Authorized Official Name and Position | Ernest Leuci (PRESIDENT CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6314767119 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ernest Leuci Lcsw Pc 3 Premier Ct Port Jefferson Station NY 11776-3198 Ph: (631) 476-7119 | Ernest Leuci Lcsw Pc 3 Premier Ct Port Jefferson Station NY 11776-3198 Ph: (631) 476-7119 |
| NPI Number | 1881627388 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 03/31/2022 |
| Certification Date | 03/31/2022 |
| Medicare PECOS PAC ID | 8325041874 |
|---|---|
| Medicare Enrollment ID | O20060823000116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881627388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R053666-1 (New York) | Primary |
| Provider Name | Ernest J Leuci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821047002 PECOS PAC ID: 2062423098 Enrollment ID: I20060505000351 |
| Provider Name | Stacey H Leuci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801996178 PECOS PAC ID: 1557504974 Enrollment ID: I20130903000692 |
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