MEDICARE: MS. TOBY GANELES 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	081045-01	NY
2	1041C0700X	Clinical Social Worker	080851-1	NY

General Provider Information

NPI Number	:	1215237250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TOBY GANELES LCSW

Provider Business Mailing Address
First Line	:	775 BROOKLYN AVE
Second Line	:
City	:	NORTH BALDWIN
State	:	NY
Zip	:	11510-2948
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	775 BROOKLYN AVE
Second Line	:
City	:	NORTH BALDWIN
State	:	NY
Zip	:	11510-2948
Country	:	US
Telephone Number	:	516-331-1521
Fax Number	:

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

Provider Enumeration Date	:	10/25/2010
Last Update Date	:	11/07/2024

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