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NPI Code Detail

MEDICARE: AUDREY ZWICK

MEDICARE:   AUDREY  ZWICK
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 Worker084055NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2WVE061OTHERNYAGENCY MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11285628552OTHERNYAGENCY NPI

General Provider Information

NPI Number : 1659666105
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDREY ZWICK
Provider Business Mailing Address
First Line : 252 JAVA ST
Second Line : SUITE 110
City : BROOKLYN
State : NY
Zip : 11222-5424
Country : US
Telephone Number : 917-322-9485
Fax Number :
Provider Business Practice Location Address
First Line : 252 JAVA ST
Second Line : SUITE 110
City : BROOKLYN
State : NY
Zip : 11222-5424
Country : US
Telephone Number : 917-322-9485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2011
Last Update Date : 02/21/2017

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Directions to “ AUDREY ZWICK ” Practice Location

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