MEDICARE: MRS. LAURA WINIARSKY LMSW

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	104100000X	Social Worker	075208-1	NY

General Provider Information

NPI Number	:	1861622235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURA WINIARSKY LMSW

Provider Business Mailing Address
First Line	:	258 BEACH 139TH ST
Second Line	:
City	:	BELLE HARBOR
State	:	NY
Zip	:	11694-1214
Country	:	US
Telephone Number	:	718-634-0674
Fax Number	:

Provider Business Practice Location Address
First Line	:	258 BEACH 139TH ST
Second Line	:
City	:	BELLE HARBOR
State	:	NY
Zip	:	11694-1214
Country	:	US
Telephone Number	:	718-634-0674
Fax Number	:

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

Provider Enumeration Date	:	07/20/2009
Last Update Date	:	07/20/2009

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