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General NPI Number Information
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NPI Number | 1063647873
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Entity Type | Individual
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Provider Name | JOAN SCHIFAUDO LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/22/2009
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Last Update Date | 05/29/2009
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Provider Practice Location Address
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Address Line | 8435 LANDER ST APT 3G
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City | BRIARWOOD
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State | NY
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Zip | 11435-2018
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Country | US
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Telephone | 718-739-0530
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Fax |
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Provider Business Mailing Address
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Address Line | 84-35 LANDER STREET
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City | BRIARWOOD
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State | NY
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Zip | 11435
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Country | US
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Telephone | 718-739-0530
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 073235-1
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License Number State | NY
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