MEDICARE: MS. JULIE ILISE HYMAN 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	076934	NY

General Provider Information

NPI Number	:	1710045711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIE ILISE HYMAN LCSW

Provider Business Mailing Address
First Line	:	501 5TH AVE
Second Line	:	ROOM 814
City	:	NEW YORK
State	:	NY
Zip	:	10017-6107
Country	:	US
Telephone Number	:	212-661-0298
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 5TH AVE
Second Line	:	ROOM 814
City	:	NEW YORK
State	:	NY
Zip	:	10017-6107
Country	:	US
Telephone Number	:	212-661-0298
Fax Number	:

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

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	10/17/2012

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