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NPI Code Detail

MEDICARE: MELINA R BOGGESS LCSW

MEDICARE:   MELINA R BOGGESS  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
1104100000XSocial Worker075579NY

General Provider Information

NPI Number : 1548459795
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELINA R BOGGESS LCSW
Provider Business Mailing Address
First Line : 3441 78TH ST
Second Line : APT. 4B
City : JACKSON HEIGHTS
State : NY
Zip : 11372-2571
Country : US
Telephone Number : 917-304-0710
Fax Number :
Provider Business Practice Location Address
First Line : 3415 77TH ST
Second Line :
City : JACKSON HEIGHTS
State : NY
Zip : 11372-2333
Country : US
Telephone Number : 917-304-0710
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2007
Last Update Date : 05/16/2013

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Directions to “ MELINA R BOGGESS LCSW” Practice Location

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