MEDICARE: BEATRIZ ADRIANA GAONA LMSW

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	104100000X	Social Worker	089882	NY

General Provider Information

NPI Number	:	1528760535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATRIZ ADRIANA GAONA LMSW

Provider Business Mailing Address
First Line	:	601 79TH ST APT E10
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-3748
Country	:	US
Telephone Number	:	718-879-2313
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 79TH ST APT E10
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-3748
Country	:	US
Telephone Number	:	718-879-2313
Fax Number	:

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

Provider Enumeration Date	:	03/21/2023
Last Update Date	:	03/21/2023

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