MEDICARE: MS. SANCHIA SAMANTHA PALMER 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	070338	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	356699	OTHER	NY	MHN
2	P2664791	OTHER	NY	OXFORD

General Provider Information

NPI Number	:	1518040971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANCHIA SAMANTHA PALMER LCSW

Provider Business Mailing Address
First Line	:	3600 FIELDSTON RD
Second Line	:	3D
City	:	BRONX
State	:	NY
Zip	:	10463-2004
Country	:	US
Telephone Number	:	917-586-7649
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 FIELDSTON RD
Second Line	:	3D
City	:	BRONX
State	:	NY
Zip	:	10463-2004
Country	:	US
Telephone Number	:	917-586-7649
Fax Number	:

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

Provider Enumeration Date	:	10/21/2006
Last Update Date	:	07/27/2012

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