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NPI Code Detail

MEDICARE: MS. MIKU TERAI LCSW

MEDICARE: MS. MIKU TERAI LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker0825031NY
21041C0700XClinical Social Worker0823421NY

General Provider Information

NPI Number : 1023450475
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MIKU TERAI LCSW
Provider Business Mailing Address
First Line : 4010 DYRE AVE
Second Line :
City : BRONX
State : NY
Zip : 10466-2510
Country : US
Telephone Number : 718-515-3000
Fax Number : 718-515-3097
Provider Business Practice Location Address
First Line : 4010 DYRE AVE
Second Line :
City : BRONX
State : NY
Zip : 10466-2510
Country : US
Telephone Number : 718-515-3000
Fax Number : 718-515-3097
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2013
Last Update Date : 09/08/2014

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