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NPI Code Detail

MEDICARE: MS. ALICE PSIRAKIS LMSW

MEDICARE:  MS. ALICE  PSIRAKIS  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
1104100000XSocial Worker059660NY

General Provider Information

NPI Number : 1346212198
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ALICE PSIRAKIS LMSW
Provider Business Mailing Address
First Line : 8701 MIDLAND PKWY
Second Line : 3D
City : JAMAICA
State : NY
Zip : 11432-4751
Country : US
Telephone Number : 347-731-1546
Fax Number : 609-562-4935
Provider Business Practice Location Address
First Line : 5250 NEW JERSEY AVE
Second Line :
City : FORT DIX
State : NJ
Zip : 08640-5017
Country : US
Telephone Number : 609-562-3141
Fax Number : 609-562-4935
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 07/08/2007

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Directions to “ MS. ALICE PSIRAKIS LMSW” Practice Location

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