MEDICARE: JASON SACA LMSW

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	130286	NY

General Provider Information

NPI Number	:	1043175334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON SACA LMSW

Provider Business Mailing Address
First Line	:	4014 20TH AVE
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11105-1617
Country	:	US
Telephone Number	:	718-844-9206
Fax Number	:

Provider Business Practice Location Address
First Line	:	3708 91ST ST
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7961
Country	:	US
Telephone Number	:	718-706-1663
Fax Number	:

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

Provider Enumeration Date	:	12/18/2025
Last Update Date	:	12/18/2025

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