MEDICARE: PAUL WELLINGTON PITTS

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	101777	NY

General Provider Information

NPI Number	:	1275028060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL WELLINGTON PITTS

Provider Business Mailing Address
First Line	:	127 HICKORY HILL RD
Second Line	:
City	:	NEWBURGH
State	:	NY
Zip	:	12550-1653
Country	:	US
Telephone Number	:	845-566-1224
Fax Number	:	845-566-1675

Provider Business Practice Location Address
First Line	:	127 HICKORY HILL RD
Second Line	:
City	:	NEWBURGH
State	:	NY
Zip	:	12550-1653
Country	:	US
Telephone Number	:	845-566-1224
Fax Number	:	845-566-1675

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

Provider Enumeration Date	:	06/25/2018
Last Update Date	:	01/21/2026

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