MEDICARE: DANA TUQAN MA, LMHC

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	101YM0800X	Mental Health Counselor	005946	NY

General Provider Information

NPI Number	:	1033514344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA TUQAN MA, LMHC

Provider Business Mailing Address
First Line	:	110 CLINTON AVE
Second Line	:	APT. 3B
City	:	BROOKLYN
State	:	NY
Zip	:	11205-2312
Country	:	US
Telephone Number	:	917-822-9024
Fax Number	:

Provider Business Practice Location Address
First Line	:	51 E 25TH ST STE 7B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10010-8209
Country	:	US
Telephone Number	:	917-822-9024
Fax Number	:

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

Provider Enumeration Date	:	10/29/2014
Last Update Date	:	10/29/2014

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