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NPI Code Detail

MEDICARE: CRYSTAL MUNFORD LMSW

MEDICARE:   CRYSTAL  MUNFORD  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 Worker079483NY

General Provider Information

NPI Number : 1841640257
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL MUNFORD LMSW
Provider Business Mailing Address
First Line : 290 LENOX AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10027-4991
Country : US
Telephone Number : 646-492-5341
Fax Number :
Provider Business Practice Location Address
First Line : 290 LENOX AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10027-4991
Country : US
Telephone Number : 646-492-5341
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2016
Last Update Date : 06/16/2016

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Directions to “ CRYSTAL MUNFORD LMSW” Practice Location

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