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General NPI Number Information
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NPI Number | 1922191246
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Entity Type | Organization
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Legal Business Name | WOODRICH CONSULTATION CENTER
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Dates
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Enumeration Date | 09/30/2006
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Last Update Date | 02/24/2010
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Provider Practice Location Address
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Address Line | 9749 WOODHAVEN BLVD
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City | OZONE PARK
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State | NY
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Zip | 11416-2312
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Country | US
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Telephone | 718-845-8481
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Fax | 516-379-2772
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Provider Business Mailing Address
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Address Line | 1971 DE KALB AVE
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City | MERRICK
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State | NY
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Zip | 11566-2602
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Country | US
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Telephone | 516-379-0525
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Fax | 516-379-2772
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Authorized Official
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Title or Position | CLINICAL COORDINATOR
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Name | MR. ANTHONY VINCENT LERRO
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Credential | CSW
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Telephone | 516-379-0525
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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 | R016844
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License Number State | NY
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