MEDICARE: LAUREL WINIFRED MAUL CSW

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	R13812	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1184843427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREL WINIFRED MAUL CSW

Provider Business Mailing Address
First Line	:	7 AMANDA CT
Second Line	:
City	:	CORTLANDT MANOR
State	:	NY
Zip	:	10567-6407
Country	:	US
Telephone Number	:	914-271-6489
Fax Number	:

Provider Business Practice Location Address
First Line	:	130B GRAND ST
Second Line	:
City	:	CROTON ON HUDSON
State	:	NY
Zip	:	10520-2307
Country	:	US
Telephone Number	:	914-271-6489
Fax Number	:

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

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	07/08/2007

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