MEDICARE: MISS ADRIENNE GLASSER 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	075413	NY

General Provider Information

NPI Number	:	1417103664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ADRIENNE GLASSER LCSW

Provider Business Mailing Address
First Line	:	7 E 68TH ST
Second Line	:	LOWER LEVEL
City	:	NEW YORK
State	:	NY
Zip	:	10065-4963
Country	:	US
Telephone Number	:	917-362-9770
Fax Number	:	212-838-2275

Provider Business Practice Location Address
First Line	:	7 E 68TH ST
Second Line	:	LOWER LEVEL
City	:	NEW YORK
State	:	NY
Zip	:	10065-4963
Country	:	US
Telephone Number	:	917-362-9770
Fax Number	:	212-838-2275

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

Provider Enumeration Date	:	08/07/2008
Last Update Date	:	08/07/2008

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