MEDICARE: MS. PATRICIA EILEEN WOSLEGER L.C.S.W.

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	72081580	NY
2	1041C0700X	Clinical Social Worker	081395	NY

General Provider Information

NPI Number	:	1265766406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA EILEEN WOSLEGER L.C.S.W.

Provider Business Mailing Address
First Line	:	1236 PACIFIC ST APT 4G
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-3032
Country	:	US
Telephone Number	:	917-763-1521
Fax Number	:

Provider Business Practice Location Address
First Line	:	1236 PACIFIC ST APT 4G
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-3032
Country	:	US
Telephone Number	:	917-763-1521
Fax Number	:

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

Provider Enumeration Date	:	09/21/2009
Last Update Date	:	04/23/2018

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