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NPI Code Detail

MEDICARE: MRS. LISA WINTERS LCSW, JD

MEDICARE: MRS. LISA WINTERS LCSW, JD
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 WorkerR041944-1NY

General Provider Information

NPI Number : 1114388063
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA WINTERS LCSW, JD
Provider Business Mailing Address
First Line : 2271 3RD AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10035-2231
Country : US
Telephone Number : 917-492-0990
Fax Number :
Provider Business Practice Location Address
First Line : 2271 3RD AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10035-2231
Country : US
Telephone Number : 917-492-0990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2016
Last Update Date : 03/18/2016

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