MEDICARE: BERNADETTE MERIZIER LMSW

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	101870-1	NY

General Provider Information

NPI Number	:	1275001950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNADETTE MERIZIER LMSW

Provider Business Mailing Address
First Line	:	1331 E 69TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5714
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 FLATBUSH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11225-6007
Country	:	US
Telephone Number	:	718-232-8600
Fax Number	:

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

Provider Enumeration Date	:	11/11/2018
Last Update Date	:	11/11/2018

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