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NPI Code Detail

MEDICARE: ROSE MARIE TAVERAS LMSW

MEDICARE: ROSE MARIE TAVERAS 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 Worker078518NY

General Provider Information

NPI Number : 1649509456
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSE MARIE TAVERAS LMSW
Provider Business Mailing Address
First Line : 125 SCHROEDERS AVE
Second Line : APT. 15B
City : BROOKLYN
State : NY
Zip : 11239-2222
Country : US
Telephone Number : 718-245-2231
Fax Number :
Provider Business Practice Location Address
First Line : 2857 LINDEN BLVD
Second Line :
City : BROOKLYN
State : NY
Zip : 11208-5126
Country : US
Telephone Number : 718-235-3100
Fax Number : 718-277-0822
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2009
Last Update Date : 12/08/2009

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Directions to “ ROSE MARIE TAVERAS LMSW” Practice Location

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