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NPI Code Detail

MEDICARE: MR. RICHARD SLIZESKI LMSW

MEDICARE: MR. RICHARD SLIZESKI LMSW
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
1104100000XSocial Worker067077NY

General Provider Information

NPI Number : 1720369242
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICHARD SLIZESKI LMSW
Provider Business Mailing Address
First Line : 1900B RALPH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-5302
Country : US
Telephone Number : 347-409-8784
Fax Number : 718-253-8590
Provider Business Practice Location Address
First Line : 1900B RALPH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-5302
Country : US
Telephone Number : 347-409-8784
Fax Number : 718-253-8590
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2011
Last Update Date : 08/30/2011

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