MEDICARE: ANN M. ROTHSCHILD 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	069506	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	329683	OTHER		MHN PRACTIONER ID NUMBER
2	11533090	OTHER		CAQH PROVIDER ID
3	069506	OTHER	NY	STATE LICENSE

General Provider Information

NPI Number	:	1871667790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN M. ROTHSCHILD LCSW

Provider Business Mailing Address
First Line	:	23 E 20TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-1326
Country	:	US
Telephone Number	:	917-701-4942
Fax Number	:	212-673-4015

Provider Business Practice Location Address
First Line	:	23 E 20TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-1326
Country	:	US
Telephone Number	:	917-701-4942
Fax Number	:	212-673-4015

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	07/08/2007

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