MEDICARE: MS. AMY GELLES 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	023784	NY

General Provider Information

NPI Number	:	1245435650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMY GELLES CSW

Provider Business Mailing Address
First Line	:	6031 HUXLEY AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10471-1806
Country	:	US
Telephone Number	:	914-636-4440
Fax Number	:	914-636-3237

Provider Business Practice Location Address
First Line	:	6031 HUXLEY AVE
Second Line	:	70 GRAND STREET NEW ROCHELLE NEW YORK 10801
City	:	BRONX
State	:	NY
Zip	:	10471-1806
Country	:	US
Telephone Number	:	914-636-4440
Fax Number	:	914-636-3237

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

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	10/09/2024

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