NPI Index

MR. KENNETH SERGIACOMI, L.M.S.W.

Social Worker

Active Individual
NPI: 1336355395

Practice Address

1050 HALLOCK AVE
SUITE 4
Port Jefferson Station, NY 11776

Phone: (631) 384-0624

Specialties

Specialty Code Primary License
Social Worker 104100000X Yes 0735881-1 (NY)
Counselor 101Y00000X No 0735881-1 (NY)

Frequently Asked Questions

NPI 1336355395 is the National Provider Identifier for MR. KENNETH SERGIACOMI, L.M.S.W., a Social Worker provider located in Port Jefferson Station, NY. This NPI was enumerated on May 15, 2007.
MR. KENNETH SERGIACOMI, L.M.S.W. practices at 1050 HALLOCK AVE, SUITE 4, Port Jefferson Station, NY 11776.

Quick Facts

NPI
1336355395
Type
Individual
Enumerated
May 15, 2007
Last Updated
Oct 17, 2007

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