MEDICARE: MS. ABIGAIL STRUBEL M.A., 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	081319-1	NY

General Provider Information

NPI Number	:	1568792158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ABIGAIL STRUBEL M.A., LCSW

Provider Business Mailing Address
First Line	:	132 W 125TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-4439
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	132 W 125TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-4439
Country	:	US
Telephone Number	:	212-864-0904
Fax Number	:

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

Provider Enumeration Date	:	01/05/2010
Last Update Date	:	01/29/2014

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