Healthcare Provider Details

I. General information

NPI: 1982010872
Provider Name (Legal Business Name): CLAIRE GELLRICH MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2014
Last Update Date: 07/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1419 SHAKESPEARE AVE
BRONX NY
10452-1851
US

IV. Provider business mailing address

1419 SHAKESPEARE AVE
BRONX NY
10452-1851
US

V. Phone/Fax

Practice location:
  • Phone: 718-732-7080
  • Fax: 718-732-7090
Mailing address:
  • Phone: 718-732-7080
  • Fax: 718-732-7090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: