MEDICARE: ERICA SAVA PARK 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	104100000X	Social Worker

General Provider Information

NPI Number	:	1578129029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA SAVA PARK LCSW

Provider Business Mailing Address
First Line	:	155 W 72ND ST RM 505
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-3250
Country	:	US
Telephone Number	:	917-497-2760
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 W 72ND ST RM 505
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-3250
Country	:	US
Telephone Number	:	917-497-2760
Fax Number	:

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

Provider Enumeration Date	:	05/09/2019
Last Update Date	:	11/29/2023

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Directions to “ ERICA SAVA PARK LCSW” Practice Location

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