MEDICARE: MRS. BRIGITTA LALONE 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	R046943	NY

General Provider Information

NPI Number	:	1700016318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRIGITTA LALONE LCSW

Provider Business Mailing Address
First Line	:	3800 RAILROAD AVE
Second Line	:	P.O. BOX 538
City	:	WILLIAMSON
State	:	NY
Zip	:	14589-9340
Country	:	US
Telephone Number	:	315-945-8530
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 RAILROAD AVE
Second Line	:
City	:	WILLIAMSON
State	:	NY
Zip	:	14589-9340
Country	:	US
Telephone Number	:	315-945-8530
Fax Number	:

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

Provider Enumeration Date	:	07/16/2009
Last Update Date	:	07/16/2009

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