MEDICARE: MONICA MONSERAY SUAREZ 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	1041C0700X	Clinical Social Worker
2	1041C0700X	Clinical Social Worker	100456	NY

General Provider Information

NPI Number	:	1356726822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA MONSERAY SUAREZ LMSW

Provider Business Mailing Address
First Line	:	140-15B SANFORD AVE
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11355
Country	:	US
Telephone Number	:	718-358-8288
Fax Number	:	718-358-5265

Provider Business Practice Location Address
First Line	:	16010 89TH AVE APT 9M
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11432-3918
Country	:	US
Telephone Number	:	347-456-2724
Fax Number	:

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

Provider Enumeration Date	:	07/27/2015
Last Update Date	:	05/12/2020

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