MEDICARE: MS. MARIAN M INGUANZO LMSW

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
1	104100000X	Social Worker	623	CT

General Provider Information

NPI Number	:	1114882768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIAN M INGUANZO LMSW

Provider Business Mailing Address
First Line	:	1439 EAST AVE APT 6H
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-7530
Country	:	US
Telephone Number	:	646-474-7548
Fax Number	:

Provider Business Practice Location Address
First Line	:	1439 EAST AVE APT 6H
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-7530
Country	:	US
Telephone Number	:	646-474-7548
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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