MEDICARE: ANNA JARMILA NEMECKOVA-GULACK

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1891454484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA JARMILA NEMECKOVA-GULACK

Provider Business Mailing Address
First Line	:	66 WILLOW AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-1829
Country	:	US
Telephone Number	:	718-808-1358
Fax Number	:

Provider Business Practice Location Address
First Line	:	66 WILLOW AVE STE 202
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-1829
Country	:	US
Telephone Number	:	718-701-0513
Fax Number	:

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

Provider Enumeration Date	:	12/11/2021
Last Update Date	:	11/22/2022

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Directions to “ ANNA JARMILA NEMECKOVA-GULACK ” Practice Location

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