| Mark B Cantales, Licensed Clinical Social Worker,pc | |
|
217 Jefferson Ave Endicott NY 13760-5244 | |
| (607) 372-1020 | |
| (607) 239-5328 |
| Full Name | Mark B Cantales, Licensed Clinical Social Worker,pc |
|---|---|
| Speciality | Social Worker |
| Location | 217 Jefferson Ave, Endicott, New York |
| Authorized Official Name and Position | Mark Cantales (PRESIDENT) |
| Authorized Official Contact | 6073721020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark B Cantales, Licensed Clinical Social Worker,pc 217 Jefferson Ave Endicott NY 13760-5244 Ph: (607) 372-1020 | Mark B Cantales, Licensed Clinical Social Worker,pc 217 Jefferson Ave Endicott NY 13760-5244 Ph: (607) 372-1020 |
| NPI Number | 1164800553 |
|---|---|
| Provider Enumeration Date | 05/18/2015 |
| Last Update Date | 05/18/2015 |
| Medicare PECOS PAC ID | 7618288697 |
|---|---|
| Medicare Enrollment ID | O20150617001056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164800553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 069788R (New York) | Primary |
| Provider Name | Mark B Cantales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922162643 PECOS PAC ID: 5890722532 Enrollment ID: I20050725000371 |
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