MEDICARE: SAMUEL D BARSANO

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	104100000X	Social Worker	105207	NY

General Provider Information

NPI Number	:	1013489509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL D BARSANO

Provider Business Mailing Address
First Line	:	1922 E 18TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3410
Country	:	US
Telephone Number	:	191-769-2868
Fax Number	:

Provider Business Practice Location Address
First Line	:	1922 E 18TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3410
Country	:	US
Telephone Number	:	917-692-8683
Fax Number	:

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

Provider Enumeration Date	:	12/20/2018
Last Update Date	:	12/20/2018

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Directions to “ SAMUEL D BARSANO ” Practice Location

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