MEDICARE: MS. ERNA PEGGY NEUMANN ANP; PMHNP; PMHNP

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	P048447-1	NY
2	101YM0800X	Mental Health Counselor	F401185	NY
3	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	F303841	NY

General Provider Information

NPI Number	:	1487617122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERNA PEGGY NEUMANN ANP; PMHNP; PMHNP

Provider Business Mailing Address
First Line	:	330 E 33RD ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-9444
Country	:	US
Telephone Number	:	212-447-5278
Fax Number	:	212-481-3826

Provider Business Practice Location Address
First Line	:	102 W 75TH ST STE 107
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-1904
Country	:	US
Telephone Number	:	212-874-5400
Fax Number	:	212-874-1560

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

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	04/14/2009

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