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NPI Code Detail

MEDICARE: RAPHAEL SPIRO LMSW

MEDICARE: RAPHAEL SPIRO 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 Worker105235NY
21041C0700XClinical Social Worker102750NY

General Provider Information

NPI Number : 1629545785
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAPHAEL SPIRO LMSW
Provider Business Mailing Address
First Line : 111 E 210TH ST
Second Line :
City : BRONX
State : NY
Zip : 10467-2401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3959 BROADWAY
Second Line :
City : NEW YORK
State : NY
Zip : 10032-1559
Country : US
Telephone Number : 929-637-2370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2018
Last Update Date : 04/14/2026

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Directions to “ RAPHAEL SPIRO LMSW” Practice Location

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