MEDICARE: LINDA S KURTZ MSW

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	R033318-1	NY

General Provider Information

NPI Number	:	1245465921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA S KURTZ MSW

Provider Business Mailing Address
First Line	:	275 LOCUST AVE
Second Line	:
City	:	RYE
State	:	NY
Zip	:	10580-1636
Country	:	US
Telephone Number	:	914-967-5530
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 THEODORE FREMD AVE
Second Line	:	SUITE 206 SOUTH
City	:	RYE
State	:	NY
Zip	:	10580-1410
Country	:	US
Telephone Number	:	914-967-5530
Fax Number	:

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

Provider Enumeration Date	:	05/25/2009
Last Update Date	:	05/25/2009

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