MEDICARE: MILDRED PITTRE 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	082549-01	NY

General Provider Information

NPI Number	:	1285484162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILDRED PITTRE LMSW

Provider Business Mailing Address
First Line	:	390 1ST AVE APT 4A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10010-4938
Country	:	US
Telephone Number	:	917-450-3815
Fax Number	:

Provider Business Practice Location Address
First Line	:	390 1ST AVE APT 4A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10010-4938
Country	:	US
Telephone Number	:	917-450-3815
Fax Number	:

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

Provider Enumeration Date	:	03/25/2024
Last Update Date	:	03/25/2024

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Directions to “ MILDRED PITTRE LMSW” Practice Location

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