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NPI Code Detail

MEDICARE: STEPHANIE IBRAHIM QUERCIA

MEDICARE:   STEPHANIE  IBRAHIM QUERCIA
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 Worker

General Provider Information

NPI Number : 1053194621
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE IBRAHIM QUERCIA
Provider Business Mailing Address
First Line : 1 ELM SQ STE 2A
Second Line :
City : ANDOVER
State : MA
Zip : 01810-3986
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1 ELM SQ STE 2A
Second Line :
City : ANDOVER
State : MA
Zip : 01810-3986
Country : US
Telephone Number : 978-296-4518
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2023
Last Update Date : 08/16/2023

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Directions to “ STEPHANIE IBRAHIM QUERCIA ” Practice Location

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