MEDICARE: MS. KATHY EDDY SALAZAR SWI

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1750028072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHY EDDY SALAZAR SWI

Provider Business Mailing Address
First Line	:	370 OCEAN PKWY APT 10F
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-4623
Country	:	US
Telephone Number	:	347-585-1120
Fax Number	:

Provider Business Practice Location Address
First Line	:	370 OCEAN PKWY APT 10F
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-4623
Country	:	US
Telephone Number	:	347-585-1120
Fax Number	:

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

Provider Enumeration Date	:	05/18/2022
Last Update Date	:	05/18/2022

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