MEDICARE: ENDRI HORANLLI L.C.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
1	104100000X	Social Worker	088175	NY
2	1041C0700X	Clinical Social Worker	085204	NY

General Provider Information

NPI Number	:	1881035251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ENDRI HORANLLI L.C.S.W.

Provider Business Mailing Address
First Line	:	1330 BAY RIDGE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-6116
Country	:	US
Telephone Number	:	347-987-0797
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 BAY RIDGE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-6116
Country	:	US
Telephone Number	:	347-987-0797
Fax Number	:

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

Provider Enumeration Date	:	07/12/2013
Last Update Date	:	09/12/2022

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Directions to “ ENDRI HORANLLI L.C.S.W.” Practice Location

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