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NPI Code Detail

MEDICARE: MRS. SVETLANA GRITSKO LCSW

MEDICARE: MRS. SVETLANA GRITSKO LCSW
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 Worker069929NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053424184
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SVETLANA GRITSKO LCSW
Provider Business Mailing Address
First Line : 485 GETZ AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10312-3851
Country : US
Telephone Number : 718-966-0308
Fax Number :
Provider Business Practice Location Address
First Line : 2020 CONEY ISLAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-2329
Country : US
Telephone Number : 718-676-4261
Fax Number : 718-676-4263
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2006
Last Update Date : 09/24/2008

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