MEDICARE: JENNIFER SHAPIRO-LEE 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	104100000X	Social Worker

General Provider Information

NPI Number	:	1629357660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER SHAPIRO-LEE LCSW

Provider Business Mailing Address
First Line	:	70 GLEN COVE RD STE 207
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1730
Country	:	US
Telephone Number	:	917-533-1725
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 GLEN COVE RD STE 207
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1730
Country	:	US
Telephone Number	:	917-533-1725
Fax Number	:

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

Provider Enumeration Date	:	08/09/2011
Last Update Date	:	09/19/2018

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