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NPI Code Detail

MEDICARE: ANDREW KRELL

MEDICARE: ANDREW KRELL
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 Worker

General Provider Information

NPI Number : 1407909674
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW KRELL
Provider Business Mailing Address
First Line : 189 MONTAGUE ST
Second Line : SUITE 418
City : BROOKLYN
State : NY
Zip : 11201-3610
Country : US
Telephone Number : 718-875-5625
Fax Number : 718-875-6876
Provider Business Practice Location Address
First Line : 819 GRAND ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11211-5001
Country : US
Telephone Number : 718-388-5176
Fax Number : 718-388-6159
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 07/08/2007

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