MEDICARE: MALKA BELGROD LCSW

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		NY
2	1041C0700X	Clinical Social Worker	084518	NY

General Provider Information

NPI Number	:	1306113212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALKA BELGROD LCSW

Provider Business Mailing Address
First Line	:	8229 215TH ST
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11427-1407
Country	:	US
Telephone Number	:	718-809-4395
Fax Number	:

Provider Business Practice Location Address
First Line	:	21010 UNION TPKE
Second Line	:
City	:	HOLLIS HILLS
State	:	NY
Zip	:	11364-3240
Country	:	US
Telephone Number	:	718-809-4395
Fax Number	:

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

Provider Enumeration Date	:	11/20/2011
Last Update Date	:	06/01/2022

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