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NPI Code Detail

MEDICARE: MS. MADELINE L GLEICH LCSW

MEDICARE:  MS. MADELINE L GLEICH  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
11041C0700XClinical Social WorkerPR013399-1NY

General Provider Information

NPI Number : 1639233455
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MADELINE L GLEICH LCSW
Provider Business Mailing Address
First Line : 250 RIVERSIDE DR
Second Line : #43
City : NEW YORK
State : NY
Zip : 10025-6146
Country : US
Telephone Number : 212-864-7369
Fax Number : 212-316-2534
Provider Business Practice Location Address
First Line : 250 RIVERSIDE DR
Second Line : #43
City : NEW YORK
State : NY
Zip : 10025-6146
Country : US
Telephone Number : 212-864-7369
Fax Number : 212-316-2534
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2006
Last Update Date : 09/30/2009

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Directions to “ MS. MADELINE L GLEICH LCSW” Practice Location

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