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General NPI Number Information
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NPI Number | 1043450414
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Entity Type | Individual
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Provider Name | EVA BRAUN LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/25/2009
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Last Update Date | 02/15/2011
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Provider Practice Location Address
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Address Line | 6435 102ND ST
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City | REGO PARK
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State | NY
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Zip | 11374-3658
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Country | US
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Telephone | 718-896-7130
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Fax |
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Provider Business Mailing Address
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Address Line | 6503 ALDERTON ST
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City | REGO PARK
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State | NY
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Zip | 11374-5013
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Country | US
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Telephone | 718-997-0975
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 065675-1
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License Number State | NY
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