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NPI Code Detail

MEDICARE: ABIGAIL JUAREZ-KARIC LCSW

MEDICARE: ABIGAIL JUAREZ-KARIC 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 Worker034914NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1040426033418OTHERNYFIDELIS PROVIDER NUMBER

General Provider Information

NPI Number : 1548375090
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL JUAREZ-KARIC LCSW
Provider Business Mailing Address
First Line : 145 W 15TH ST
Second Line : 2ND FLOOR
City : NEW YORK
State : NY
Zip : 10011-6701
Country : US
Telephone Number : 212-924-6324
Fax Number : 212-691-5635
Provider Business Practice Location Address
First Line : 217 HAVEMEYER ST
Second Line : 4TH FLOOR
City : BROOKLYN
State : NY
Zip : 11211-6277
Country : US
Telephone Number : 718-963-4430
Fax Number : 718-963-0814
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2006
Last Update Date : 08/13/2010

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