MEDICARE: MARIA YVETTE CARREON NARIO LMSW

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	092502	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	092502	OTHER	NY	LMSW

General Provider Information

NPI Number	:	1194125294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA YVETTE CARREON NARIO LMSW

Provider Business Mailing Address
First Line	:	290 LENOX AVE
Second Line	:	LOWER LEVEL
City	:	NEW YORK
State	:	NY
Zip	:	10027-4991
Country	:	US
Telephone Number	:	212-289-2378
Fax Number	:

Provider Business Practice Location Address
First Line	:	290 LENOX AVE
Second Line	:	LOWER LEVEL
City	:	NEW YORK
State	:	NY
Zip	:	10027-4991
Country	:	US
Telephone Number	:	212-289-2378
Fax Number	:

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

Provider Enumeration Date	:	08/26/2014
Last Update Date	:	08/26/2014

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