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NPI Code Detail

MEDICARE: MS. JULIE A LIST LCSW

MEDICARE:  MS. JULIE A LIST  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
11041C0700XClinical Social WorkerR032010-1NY

General Provider Information

NPI Number : 1861572489
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JULIE A LIST LCSW
Provider Business Mailing Address
First Line : 605 W 111TH ST APT 44
Second Line :
City : NEW YORK
State : NY
Zip : 10025-1810
Country : US
Telephone Number : 212-222-4487
Fax Number :
Provider Business Practice Location Address
First Line : 750 ASTOR AVE
Second Line : JBFCS
City : BRONX
State : NY
Zip : 10467-9304
Country : US
Telephone Number : 718-882-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 07/08/2007

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Directions to “ MS. JULIE A LIST LCSW” Practice Location

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