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NPI Code Detail

MEDICARE: MRS. SUSAN DARA PEREL

MEDICARE: MRS. SUSAN DARA PEREL
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 WorkerR034845NY

General Provider Information

NPI Number : 1194769364
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN DARA PEREL
Provider Business Mailing Address
First Line : 788 TODT HILL RD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10304-1327
Country : US
Telephone Number : 718-667-3800
Fax Number : 718-980-9281
Provider Business Practice Location Address
First Line : 27 NEW DORP LN
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10306-2322
Country : US
Telephone Number : 718-667-3597
Fax Number : 718-667-3590
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2006
Last Update Date : 03/15/2010

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Directions to “ MRS. SUSAN DARA PEREL ” Practice Location

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