MEDICARE: MR. MITCHELL MAY MSW LCSW BCD

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	104100000X	Social Worker	PR0231041	NY

General Provider Information

NPI Number	:	1619042579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MITCHELL MAY MSW LCSW BCD

Provider Business Mailing Address
First Line	:	320 WEST 90TH STREET
Second Line	:
City	:	NEW YORK CITY
State	:	NY
Zip	:	10024
Country	:	US
Telephone Number	:	212-799-0273
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 WEST 90TH STREET
Second Line	:
City	:	NEW YORK CITY
State	:	NY
Zip	:	10024
Country	:	US
Telephone Number	:	212-799-0273
Fax Number	:

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

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	07/08/2007

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