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NPI Code Detail

MEDICARE: CAPUCINE FURTICK L.M.S.W

MEDICARE:   CAPUCINE  FURTICK  L.M.S.W
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 Worker

General Provider Information

NPI Number : 1881014082
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAPUCINE FURTICK L.M.S.W
Provider Business Mailing Address
First Line : 910 GRAND CONCOURSE
Second Line : #3A
City : BRONX
State : NY
Zip : 10451-2719
Country : US
Telephone Number : 718-588-9308
Fax Number :
Provider Business Practice Location Address
First Line : 910 GRAND CONCOURSE
Second Line : #3A
City : BRONX
State : NY
Zip : 10451-2719
Country : US
Telephone Number : 718-588-9308
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2014
Last Update Date : 04/26/2014

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