Individual
AVIVA E SALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
44 SIMPSON DR, OLD BETHPAGE, NY 11804-1220
(516) 293-4060
Mailing address
44 SIMPSON DR, OLD BETHPAGE, NY 11804-1220
(516) 293-4060
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R051415
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
460598
VALUE OPTIONS PROVIDER ID
NY
Enumeration date
01/10/2007
Last updated
07/08/2007
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