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NPI Code Detail

MEDICARE: MS. DAPHNEY MARY RENE LMSW

MEDICARE:  MS. DAPHNEY MARY RENE  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
11041C0700XClinical Social Worker070883NY

General Provider Information

NPI Number : 1538309091
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DAPHNEY MARY RENE LMSW
Provider Business Mailing Address
First Line : 1669 BEDFORD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11225-2009
Country : US
Telephone Number : 718-467-7200
Fax Number : 718-467-7115
Provider Business Practice Location Address
First Line : 1669 BEDFORD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11225-2009
Country : US
Telephone Number : 718-467-7200
Fax Number : 718-467-7115
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2009
Last Update Date : 10/08/2009

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Directions to “ MS. DAPHNEY MARY RENE LMSW” Practice Location

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