MEDICARE: MISS MIRIAM ECHEVARRIA 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	1041C0700X	Clinical Social Worker	086350-1	NY

General Provider Information

NPI Number	:	1851713630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MIRIAM ECHEVARRIA LMSW

Provider Business Mailing Address
First Line	:	1730 MULFORD AVE APT 18L
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-4332
Country	:	US
Telephone Number	:	718-320-5269
Fax Number	:

Provider Business Practice Location Address
First Line	:	1730 MULFORD AVE APT 18L
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-4332
Country	:	US
Telephone Number	:	718-320-5269
Fax Number	:

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

Provider Enumeration Date	:	01/13/2014
Last Update Date	:	07/07/2014

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