MEDICARE: CYNTHIA L TEPLITZKY 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	1041S0200X	School Social Worker

General Provider Information

NPI Number	:	1750042651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA L TEPLITZKY LCSW

Provider Business Mailing Address
First Line	:	59 TIPPERARY WAY
Second Line	:
City	:	BALLSTON LAKE
State	:	NY
Zip	:	12019-2235
Country	:	US
Telephone Number	:	860-558-2453
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 JONES RD
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-5714
Country	:	US
Telephone Number	:	518-584-7383
Fax Number	:

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

Provider Enumeration Date	:	01/04/2022
Last Update Date	:	01/04/2022

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