Individual
ANTONIO RUBERTO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
333 N MAIN ST, FREEPORT, NY 11520-1231
(516) 623-3322
Mailing address
380 BAUER PL, MINEOLA, NY 11501-1340
(516) 623-3322
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
075888-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
075888-1
LICENSE
NY
Enumeration date
04/30/2010
Last updated
04/30/2010
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