MEDICARE: EMMA ESTEFANIA TOVAR 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		NY

General Provider Information

NPI Number	:	1457843906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA ESTEFANIA TOVAR LCSW

Provider Business Mailing Address
First Line	:	12602 82ND AVE
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-1225
Country	:	US
Telephone Number	:	187-575-4545
Fax Number	:

Provider Business Practice Location Address
First Line	:	12602 82ND AVE
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-1225
Country	:	US
Telephone Number	:	718-575-4545
Fax Number	:

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

Provider Enumeration Date	:	05/31/2018
Last Update Date	:	03/27/2025

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