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NPI Code Detail

MEDICARE: DR. TIMOTHY LEE HUNT PHD, LCSW

MEDICARE: DR. TIMOTHY LEE HUNT PHD, 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
11041C0700XClinical Social WorkerR045041-1NY

General Provider Information

NPI Number : 1891204723
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY LEE HUNT PHD, LCSW
Provider Business Mailing Address
First Line : 140 E17TH STREET
Second Line : 6B
City : NEW YORK
State : NY
Zip : 10003
Country : US
Telephone Number : 917-991-0693
Fax Number :
Provider Business Practice Location Address
First Line : 1255 AMSTERDAM AVE RM 806
Second Line :
City : NEW YORK
State : NY
Zip : 10027-5927
Country : US
Telephone Number : 917-991-0693
Fax Number : 917-991-0693
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2017
Last Update Date : 09/22/2017

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