MEDICARE: MS. SANDRA FLORENCE HAMBERGER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R330311	NY

General Provider Information

NPI Number	:	1003992256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA FLORENCE HAMBERGER LCSW

Provider Business Mailing Address
First Line	:	173 09 JEWEL AVENUE FLUSHING
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	11365-3423
Country	:	US
Telephone Number	:	718-969-8087
Fax Number	:	718-470-9402

Provider Business Practice Location Address
First Line	:	173 09 JEWEL AVENUE
Second Line	:	FLUSHING
City	:	NEW YORK
State	:	NY
Zip	:	11365-3423
Country	:	US
Telephone Number	:	718-969-8087
Fax Number	:	718-470-9402

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	07/08/2007

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