MEDICARE: NANCY BACHMAN

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

General Provider Information

NPI Number	:	1275910432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NANCY BACHMAN

Provider Business Mailing Address
First Line	:	143 APPLE RIDGE RD
Second Line	:
City	:	WOODCLIFF LAKE
State	:	NJ
Zip	:	07677-8151
Country	:	US
Telephone Number	:	917-685-7927
Fax Number	:

Provider Business Practice Location Address
First Line	:	48 BURD ST
Second Line	:
City	:	NYACK
State	:	NY
Zip	:	10960-3226
Country	:	US
Telephone Number	:	917-685-7927
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL SOCIAL WORKER
Name	:	NANCY ROSEL BACHMAN
Credential	:	LCSW-R
Telephone Number	:	917-685-7927

Provider Enumeration Date	:	04/27/2015
Last Update Date	:	04/27/2015

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