MEDICARE: SHEENA AUDAIN

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	104100000X	Social Worker	096729-1	NY

General Provider Information

NPI Number	:	1184179491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEENA AUDAIN

Provider Business Mailing Address
First Line	:	12049 227TH ST
Second Line	:
City	:	CAMBRIA HEIGHTS
State	:	NY
Zip	:	11411-2129
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12049 227TH ST
Second Line	:
City	:	CAMBRIA HEIGHTS
State	:	NY
Zip	:	11411-2129
Country	:	US
Telephone Number	:	516-884-4633
Fax Number	:

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

Provider Enumeration Date	:	08/17/2016
Last Update Date	:	08/17/2016

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Directions to “ SHEENA AUDAIN ” Practice Location

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