Provider Demographics
NPI:1548456361
Name:DIGIROLAMO, PATRICK (LCSW)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:
Last Name:DIGIROLAMO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BRANIFF DR
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-1903
Mailing Address - Country:US
Mailing Address - Phone:315-488-4066
Mailing Address - Fax:
Practice Address - Street 1:9 BRANIFF DR
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-1903
Practice Address - Country:US
Practice Address - Phone:315-488-4066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-16
Last Update Date:2007-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0224731101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56975BMedicare PIN