=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851509525
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARBARA J, TAWIL LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 235 BEACH 134TH ST
-----------------------------------------------------
City | BELLE HARBOR
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11694-1439
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-634-2254
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 235 BEACH 134TH ST
-----------------------------------------------------
City | BELLE HARBOR
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11694-1439
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-634-2254
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 070607-01
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------