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NPI Code Detail

MEDICARE: MR. MICHAEL R LARDIERE LCSW

MEDICARE:  MR. MICHAEL R LARDIERE  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 WorkerR043799-1NY

General Provider Information

NPI Number : 1447432828
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL R LARDIERE LCSW
Provider Business Mailing Address
First Line : 115 93RD ST
Second Line : 2NDFL
City : BROOKLYN
State : NY
Zip : 11209-6201
Country : US
Telephone Number : 914-261-8370
Fax Number : 718-679-9280
Provider Business Practice Location Address
First Line : 115 93RD ST
Second Line : 2NDFL
City : BROOKLYN
State : NY
Zip : 11209-6201
Country : US
Telephone Number : 914-261-8370
Fax Number : 718-679-9280
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2007
Last Update Date : 11/28/2007

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Directions to “ MR. MICHAEL R LARDIERE LCSW” Practice Location

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