MEDICARE: MRS. ANN BRAMMER LCSWR

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	R049572	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	107384	OTHER	NY	HEALTHNET

General Provider Information

NPI Number	:	1255488334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANN BRAMMER LCSWR

Provider Business Mailing Address
First Line	:	11 CROWN HILL RD
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-6475
Country	:	US
Telephone Number	:	914-668-8938
Fax Number	:	914-668-2545

Provider Business Practice Location Address
First Line	:	6 GRAMATAN AVE
Second Line	:	SUITE 401
City	:	MT VERNON
State	:	NY
Zip	:	10550-3208
Country	:	US
Telephone Number	:	914-668-8938
Fax Number	:	914-668-2545

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

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	10/16/2007

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