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NPI Code Detail

MEDICARE: MS. DELETT ANTONETT WALKER LMSW

MEDICARE: MS. DELETT ANTONETT WALKER LMSW
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 Worker9687866NY

General Provider Information

NPI Number : 1558993824
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DELETT ANTONETT WALKER LMSW
Provider Business Mailing Address
First Line : 9027 SUTPHIN BLVD STE 5
Second Line :
City : JAMAICA
State : NY
Zip : 11435-3648
Country : US
Telephone Number : 718-526-8400
Fax Number : 718-525-8424
Provider Business Practice Location Address
First Line : 9027 SUTPHIN BLVD STE 5
Second Line :
City : JAMAICA
State : NY
Zip : 11435-3648
Country : US
Telephone Number : 718-526-8400
Fax Number : 718-526-8424
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2020
Last Update Date : 02/05/2020

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