MEDICARE: MRS. AMY RUTH MORIK 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	074718-1	NY

General Provider Information

NPI Number	:	1659686574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY RUTH MORIK LCSW

Provider Business Mailing Address
First Line	:	101 WINDSOR RD
Second Line	:
City	:	TENAFLY
State	:	NJ
Zip	:	07670-2615
Country	:	US
Telephone Number	:	201-266-4847
Fax Number	:

Provider Business Practice Location Address
First Line	:	251 E 77TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-2045
Country	:	US
Telephone Number	:	212-288-1450
Fax Number	:

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

Provider Enumeration Date	:	08/16/2010
Last Update Date	:	08/16/2010

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