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NPI Code Detail

MEDICARE: TATYANA SHMIDT LCSW

MEDICARE: TATYANA SHMIDT LCSW
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 Worker054145NY

General Provider Information

NPI Number : 1205869385
Entity Type Code : Individual
Provider Name (Legal Business Name) : TATYANA SHMIDT LCSW
Provider Business Mailing Address
First Line : 585 SCHENECTADY AVE
Second Line : MANAGED CARE DEPT. - 6TH FLOOR, BLUMBERG BLDG.
City : BROOKLYN
State : NY
Zip : 11203-1809
Country : US
Telephone Number : 718-604-5469
Fax Number : 718-604-5527
Provider Business Practice Location Address
First Line : 585 SCHENECTADY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-1822
Country : US
Telephone Number : 718-604-5281
Fax Number : 718-604-5527
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2006
Last Update Date : 03/07/2008

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Directions to “ TATYANA SHMIDT LCSW” Practice Location

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