MEDICARE: MS. SHOBHNA VORA 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
1	1041C0700X	Clinical Social Worker	LCSWR016035	NY

General Provider Information

NPI Number	:	1063574283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHOBHNA VORA LCSW

Provider Business Mailing Address
First Line	:	601 EAST 20TH STREET
Second Line	:	#12 B
City	:	NEW YORK CITY
State	:	NY
Zip	:	10010
Country	:	US
Telephone Number	:	212-677-5315
Fax Number	:	212-677-5315

Provider Business Practice Location Address
First Line	:	601 EAST 20TH STREET
Second Line	:	#12 B
City	:	NEW YORK CITY
State	:	NY
Zip	:	10010
Country	:	US
Telephone Number	:	212-677-5315
Fax Number	:	212-677-5315

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

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	07/08/2007

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