MEDICARE: MS. ELIZABETH H WINSLOW 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
1	1041C0700X	Clinical Social Worker	R0581801	NY

General Provider Information

NPI Number	:	1619945565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH H WINSLOW LCSW

Provider Business Mailing Address
First Line	:	PAHC 1075 STEPHENSON AVE
Second Line	:	ATTN CREDENTIALS OFFICE
City	:	FORT MONMOUTH
State	:	NJ
Zip	:	07703-5000
Country	:	US
Telephone Number	:	732-532-0182
Fax Number	:	732-532-0194

Provider Business Practice Location Address
First Line	:	114 WHITE AVE
Second Line	:	BLDG 114
City	:	BROOKLYN
State	:	NY
Zip	:	11252
Country	:	US
Telephone Number	:	718-630-4242
Fax Number	:	718-630-4337

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	07/08/2007

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