MEDICARE: DEBORAH ANTAR 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	075822	NY
2	1041C0700X	Clinical Social Worker	R075822	NY

General Provider Information

NPI Number	:	1699937284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH ANTAR LCSW

Provider Business Mailing Address
First Line	:	245 EAST 72 STREET
Second Line	:	# 31A
City	:	NEW YORK
State	:	NY
Zip	:	10021-4553
Country	:	US
Telephone Number	:	212-744-7444
Fax Number	:

Provider Business Practice Location Address
First Line	:	245 EAST 72 STREET
Second Line	:	SUITE 1D
City	:	NEW YORK
State	:	NY
Zip	:	10021-4553
Country	:	US
Telephone Number	:	212-744-7444
Fax Number	:

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

Provider Enumeration Date	:	06/25/2008
Last Update Date	:	06/13/2011

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