MEDICARE: ELIZABETH MORGAN EUGENIO

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	106805	NY

General Provider Information

NPI Number	:	1043957079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH MORGAN EUGENIO

Provider Business Mailing Address
First Line	:	200 W 26TH ST APT 8D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-6748
Country	:	US
Telephone Number	:	312-953-2280
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 W 72ND ST RM 505
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-3250
Country	:	US
Telephone Number	:	917-497-2760
Fax Number	:

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

Provider Enumeration Date	:	05/20/2022
Last Update Date	:	05/20/2022

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