MEDICARE: MS. GAIL RISE CHOTINER MSW, 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
1	1041C0700X	Clinical Social Worker	004092	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205917622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GAIL RISE CHOTINER MSW, LCSW

Provider Business Mailing Address
First Line	:	88 SALEM WALK
Second Line	:
City	:	MILFORD
State	:	CT
Zip	:	06460-7132
Country	:	US
Telephone Number	:	203-877-3011
Fax Number	:	203-877-3541

Provider Business Practice Location Address
First Line	:	1435 STATE ST
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06511-2702
Country	:	US
Telephone Number	:	203-494-6824
Fax Number	:	203-877-3541

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

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	07/08/2007

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