Basic Information
| Provider Information | |||||||||
| NPI: | 1235241555 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARTLEY-FERRANDINO | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 320 CARLETON AVE | ||||||||
| Address2: | |||||||||
| City: | CENTRAL ISLIP | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316634307 | ||||||||
| FaxNumber: | 6314394066 | ||||||||
| Practice Location | |||||||||
| Address1: | 790 PARK AVE | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117434516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316634300 | ||||||||
| FaxNumber: | 6314394066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 06/14/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 075038-R | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.