MEDICARE: MRS. DEBRA RADZIK-HERSTEIN MSED

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	101YS0200X	School Counselor	845396	NY

General Provider Information

NPI Number	:	1689946089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBRA RADZIK-HERSTEIN MSED

Provider Business Mailing Address
First Line	:	14147 70TH RD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-1936
Country	:	US
Telephone Number	:	646-269-9842
Fax Number	:	718-261-4938

Provider Business Practice Location Address
First Line	:	14147 70TH RD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-1936
Country	:	US
Telephone Number	:	646-269-9842
Fax Number	:	718-261-4938

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

Provider Enumeration Date	:	01/31/2012
Last Update Date	:	01/31/2012

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