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NPI Code Detail

MEDICARE: ADOLFO MARRERO LCSW

MEDICARE: ADOLFO MARRERO 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
11041C0700XClinical Social Worker073766NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1040426033413OTHERNYFIDELIS PROVIDER NUMBER

General Provider Information

NPI Number : 1164538799
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADOLFO MARRERO LCSW
Provider Business Mailing Address
First Line : 2265 3RD AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10035-2231
Country : US
Telephone Number : 212-289-6650
Fax Number :
Provider Business Practice Location Address
First Line : 2265 3RD AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10035-2231
Country : US
Telephone Number : 212-289-6650
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 07/30/2019

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