MEDICARE: MS. SANDRA BARON MSW

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	LCSW R029372-1	NY

General Provider Information

NPI Number	:	1538353768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA BARON MSW

Provider Business Mailing Address
First Line	:	171 WINDSOR PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-5917
Country	:	US
Telephone Number	:	718-768-0320
Fax Number	:	718-965-1721

Provider Business Practice Location Address
First Line	:	171 WINDSOR PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-5917
Country	:	US
Telephone Number	:	718-768-0320
Fax Number	:	718-965-1721

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

Provider Enumeration Date	:	08/30/2007
Last Update Date	:	08/30/2007

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