MEDICARE: DEBRA UFFER 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1841787892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA UFFER LCSW

Provider Business Mailing Address
First Line	:	136 BEACH 117TH ST APT 210
Second Line	:
City	:	ROCKAWAY PARK
State	:	NY
Zip	:	11694-2011
Country	:	US
Telephone Number	:	347-619-9480
Fax Number	:

Provider Business Practice Location Address
First Line	:	136 BEACH 117TH ST APT 210
Second Line	:
City	:	ROCKAWAY PARK
State	:	NY
Zip	:	11694-2011
Country	:	US
Telephone Number	:	347-619-9480
Fax Number	:

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

Provider Enumeration Date	:	04/16/2018
Last Update Date	:	04/16/2018

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