MEDICARE: JULIA CARR-ELLIS 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
1	104100000X	Social Worker	067977-1	NY

General Provider Information

NPI Number	:	1831423110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA CARR-ELLIS LMSW

Provider Business Mailing Address
First Line	:	3530 HENRY HUDSON PKWY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-1306
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3530 HENRY HUDSON PKWY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-1306
Country	:	US
Telephone Number	:	917-322-9827
Fax Number	:

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

Provider Enumeration Date	:	09/20/2009
Last Update Date	:	09/20/2009

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