MEDICARE: BETHANY JOY GINGERICH

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	:	1518827278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETHANY JOY GINGERICH

Provider Business Mailing Address
First Line	:	4854 NEW YORK 410
Second Line	:
City	:	CASTORLAND
State	:	NY
Zip	:	13620
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 MAIN ST
Second Line	:
City	:	CAMDEN
State	:	NY
Zip	:	13316-1302
Country	:	US
Telephone Number	:	315-820-2638
Fax Number	:	315-820-2638

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

Provider Enumeration Date	:	11/14/2025
Last Update Date	:	12/05/2025

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