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NPI Code Detail

MEDICARE: WENDY P LOGIN MSW

MEDICARE: WENDY P LOGIN MSW
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 Worker001255CT

General Provider Information

NPI Number : 1902841299
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY P LOGIN MSW
Provider Business Mailing Address
First Line : 27 BITTERSWEET DR
Second Line :
City : GALES FERRY
State : CT
Zip : 06335-1002
Country : US
Telephone Number : 860-464-7458
Fax Number : 708-585-0700
Provider Business Practice Location Address
First Line : 27 BITTERSWEET DR
Second Line :
City : GALES FERRY
State : CT
Zip : 06335-1002
Country : US
Telephone Number : 860-464-7458
Fax Number : 708-585-0700
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2006
Last Update Date : 07/08/2007

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