MEDICARE: SOCIAL WORK PRN

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

General Provider Information

NPI Number	:	1669677258
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOCIAL WORK PRN

Provider Business Mailing Address
First Line	:	7241 HOLLYWOOD RD
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-1211
Country	:	US
Telephone Number	:	215-641-2311
Fax Number	:

Provider Business Practice Location Address
First Line	:	7241 HOLLYWOOD RD
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-1211
Country	:	US
Telephone Number	:	215-641-2311
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ROBERT BENJAMIN PLOTKIN
Credential	:	MSW
Telephone Number	:	215-641-2311

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	08/22/2020

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