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NPI Code Detail

MEDICARE: MR. RAFAEL N LEON LMSW

MEDICARE: MR. RAFAEL N LEON 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
11041C0700XClinical Social Worker099432NY

General Provider Information

NPI Number : 1891193587
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RAFAEL N LEON LMSW
Provider Business Mailing Address
First Line : 28 DEBEVOISE ST STE 5
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-4194
Country : US
Telephone Number : 718-963-4430
Fax Number : 718-963-0814
Provider Business Practice Location Address
First Line : 28 DEBEVOISE ST STE 5
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-4194
Country : US
Telephone Number : 718-963-4430
Fax Number : 718-963-0814
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2014
Last Update Date : 11/30/2016

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