MEDICARE: MS. HILARY MARSHAK MSW, 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	101YM0800X	Mental Health Counselor	R044859-1	NY

General Provider Information

NPI Number	:	1548284789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HILARY MARSHAK MSW, LCSW

Provider Business Mailing Address
First Line	:	75 MONTGOMERY ST APT 7C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10002-6553
Country	:	US
Telephone Number	:	212-349-0011
Fax Number	:	212-349-0011

Provider Business Practice Location Address
First Line	:	24 E 12TH ST
Second Line	:	SUITE 2A-F
City	:	NEW YORK
State	:	NY
Zip	:	10003-4513
Country	:	US
Telephone Number	:	212-349-0011
Fax Number	:	212-691-6600

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	09/10/2009

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