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NPI Code Detail

MEDICARE: LYDIA H MECHANICK LCSW

MEDICARE: LYDIA H MECHANICK 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
11041C0700XClinical Social WorkerPRO13609-1NY

General Provider Information

NPI Number : 1396783312
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYDIA H MECHANICK LCSW
Provider Business Mailing Address
First Line : 57 PARK AVE
Second Line :
City : PORT WASHINGTON
State : NY
Zip : 11050-4033
Country : US
Telephone Number : 516-944-6614
Fax Number :
Provider Business Practice Location Address
First Line : 950 S OYSTER BAY RD
Second Line :
City : HICKSVILLE
State : NY
Zip : 11801-3510
Country : US
Telephone Number : 516-822-6111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2006
Last Update Date : 02/21/2008

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