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NPI 1104284777

NPI 1104284777 : MARIE G JOSEPH SOCIAL WORKER : STATEN ISLAND, NY

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General NPI Number Information
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    NPI Number           |    1104284777
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    Entity Type          |    Individual 
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    Provider Name        |    MARIE G JOSEPH SOCIAL WORKER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/10/2016
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    Last Update Date     |    02/10/2016
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Provider Practice Location Address
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    Address Line         |    2381 HYLAND BLVD 
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    City                 |    STATEN ISLAND
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    State                |    NY
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    Zip                  |    10301
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    Country              |    US
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    Telephone            |    800-277-4680
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    763 FRANKLIN AVE APT 4R 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11238-4865
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    Country              |    US
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    Telephone            |    347-489-8484
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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       |    72-096801
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    License Number State |    NY
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