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NPI Code Detail

MEDICARE: SUZANNE E TOMB LCSW-R

MEDICARE:   SUZANNE E TOMB  LCSW-R
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 WorkerR045085NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538176771
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE E TOMB LCSW-R
Provider Business Mailing Address
First Line : 9 CAREY RD
Second Line :
City : QUEENSBURY
State : NY
Zip : 12804-7880
Country : US
Telephone Number : 518-761-0300
Fax Number : 518-824-2388
Provider Business Practice Location Address
First Line : 126 SKI BOWL RD
Second Line :
City : NORTH CREEK
State : NY
Zip : 12853-2607
Country : US
Telephone Number : 518-251-2541
Fax Number : 518-251-3055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 06/12/2020

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Directions to “ SUZANNE E TOMB LCSW-R” Practice Location

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