MEDICARE: MARGIE D. KOHN L.C.S.W

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	R046750	NY

General Provider Information

NPI Number	:	1811100811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGIE D. KOHN L.C.S.W

Provider Business Mailing Address
First Line	:	PO BOX 2032
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-0500
Country	:	US
Telephone Number	:	800-677-1855
Fax Number	:

Provider Business Practice Location Address
First Line	:	8514 4TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4608
Country	:	US
Telephone Number	:	800-677-1855
Fax Number	:

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

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

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