| Shelly D'amato Llc | |
|
14 Pacio Ct Roseland NJ 07068-1121 | |
| (201) 245-4014 | |
| Not Available |
| Full Name | Shelly D'amato Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 14 Pacio Ct, Roseland, New Jersey |
| Authorized Official Name and Position | Shelly D'amato (OWNER) |
| Authorized Official Contact | 2012454014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelly D'amato Llc 14 Pacio Ct Roseland NJ 07068-1121 Ph: (201) 245-4014 | Shelly D'amato Llc 14 Pacio Ct Roseland NJ 07068-1121 Ph: (201) 245-4014 |
| NPI Number | 1972355287 |
|---|---|
| Provider Enumeration Date | 04/02/2024 |
| Last Update Date | 04/02/2024 |
| Certification Date | 04/02/2024 |
| Medicare PECOS PAC ID | 5698219251 |
|---|---|
| Medicare Enrollment ID | O20240708000716 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972355287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Shelly D'amato |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144710054 PECOS PAC ID: 3971922089 Enrollment ID: I20200923000705 |
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