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NPI Code Detail

MEDICARE: JONATHAN EBIN BLOCH L.C.S.W.

MEDICARE:   JONATHAN EBIN BLOCH  L.C.S.W.
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
11041C0700XClinical Social WorkerR045813NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1R045813OTHERNYLICENSE

General Provider Information

NPI Number : 1043428923
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN EBIN BLOCH L.C.S.W.
Provider Business Mailing Address
First Line : 175 PROSPECT PL
Second Line :
City : BROOKLYN
State : NY
Zip : 11238-3801
Country : US
Telephone Number : 718-789-6146
Fax Number :
Provider Business Practice Location Address
First Line : 175 PROSPECT PL
Second Line :
City : BROOKLYN
State : NY
Zip : 11238-3801
Country : US
Telephone Number : 718-789-6146
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 07/08/2007

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Directions to “ JONATHAN EBIN BLOCH L.C.S.W.” Practice Location

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