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NPI Code Detail

MEDICARE: LINDA AFONSO LCSW

MEDICARE: LINDA AFONSO 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 Worker070686-1NY

General Provider Information

NPI Number : 1093804650
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA AFONSO LCSW
Provider Business Mailing Address
First Line : 2527 GLEBE AVE
Second Line :
City : BRONX
State : NY
Zip : 10461-3109
Country : US
Telephone Number : 718-904-4433
Fax Number : 718-931-7307
Provider Business Practice Location Address
First Line : 2527 GLEBE AVE
Second Line :
City : BRONX
State : NY
Zip : 10461-3109
Country : US
Telephone Number : 718-904-4433
Fax Number : 718-931-7307
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 07/08/2007

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