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NPI Code Detail

MEDICARE: MS. ELIZABETH WIENER

MEDICARE: MS. ELIZABETH WIENER
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 Worker

General Provider Information

NPI Number : 1730317926
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH WIENER
Provider Business Mailing Address
First Line : 1391 NELSON AVE
Second Line :
City : BRONX
State : NY
Zip : 10452-2440
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1391 NELSON AVE
Second Line :
City : BRONX
State : NY
Zip : 10452-2440
Country : US
Telephone Number : 718-732-7080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2009
Last Update Date : 06/25/2009

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