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NPI Code Detail

MEDICARE: FOUR BRIDGES SOCIAL WORK SERVICES LCSW PC

MEDICARE: FOUR BRIDGES SOCIAL WORK SERVICES LCSW PC
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 Worker73 081136NY

General Provider Information

NPI Number : 1851721955
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOUR BRIDGES SOCIAL WORK SERVICES LCSW PC
Provider Business Mailing Address
First Line : 88 NEW DORP PLZ S
Second Line : SUITE 203
City : STATEN ISLAND
State : NY
Zip : 10306-2966
Country : US
Telephone Number : 718-815-3500
Fax Number : 718-764-6064
Provider Business Practice Location Address
First Line : 88 NEW DORP PLZ S
Second Line : SUITE 203
City : STATEN ISLAND
State : NY
Zip : 10306-2966
Country : US
Telephone Number : 718-815-3500
Fax Number : 718-764-6064
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : NANETTE FLEISCHER
Credential : LCSW
Telephone Number : 718-815-3500
Provider Enumeration Date : 11/26/2013
Last Update Date : 03/23/2015

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Directions to “FOUR BRIDGES SOCIAL WORK SERVICES LCSW PC ” Practice Location

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