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General NPI Number Information
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NPI Number | 1083450340
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Entity Type | Individual
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Provider Name | CHARLES-ANTHONY MARK FUCHS LMSW
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Gender | Male
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Dates
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Enumeration Date | 07/06/2024
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Last Update Date | 07/06/2024
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Provider Practice Location Address
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Address Line | 468 NEIGHBORHOOD ROAD 468 NEIGHBORHOOD ROAD
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City | MASTIC BEACH
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State | NY
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Zip | 11951
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Country | US
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Telephone | 631-772-6219
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Fax |
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Provider Business Mailing Address
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Address Line | 48 OLD POST RD
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City | MOUNT SINAI
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State | NY
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Zip | 11766-1100
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Country | US
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Telephone | 631-652-5001
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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 | 123926
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License Number State | NY
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