MEDICARE: CHRISTINA MARIA LIMA LCSW-R

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	043076-1	NY

General Provider Information

NPI Number	:	1245436070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA MARIA LIMA LCSW-R

Provider Business Mailing Address
First Line	:	122 DIKEMAN ST
Second Line	:	3F
City	:	BROOKLYN
State	:	NY
Zip	:	11231-1284
Country	:	US
Telephone Number	:	718-246-0512
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 W MOSHOLU PKWY S
Second Line	:	ROOM 262
City	:	BRONX
State	:	NY
Zip	:	10468-1001
Country	:	US
Telephone Number	:	718-549-8022
Fax Number	:	718-549-7977

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

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	07/08/2007

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