MEDICARE: MR. ERROL DENIS CHRISTOPHER LCSW-R

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	RO55478-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700096559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERROL DENIS CHRISTOPHER LCSW-R

Provider Business Mailing Address
First Line	:	305 E 94TH ST
Second Line	:	APARTMENT 2R
City	:	BROOKLYN
State	:	NY
Zip	:	11212-1833
Country	:	US
Telephone Number	:	718-342-3674
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 W 180TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-5905
Country	:	US
Telephone Number	:	212-543-1588
Fax Number	:	212-543-2280

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

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	07/08/2007

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Directions to “ MR. ERROL DENIS CHRISTOPHER LCSW-R” Practice Location

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