MEDICARE: MS. FRAN ANTIGONE 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
1	1041C0700X	Clinical Social Worker	R0221571	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7407532	OTHER	NY	GHI
2	110104	OTHER	NY	VALUE INS W
3	P1855603	OTHER	NY	OXFORD INSURANCE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891878187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FRAN ANTIGONE LCSW

Provider Business Mailing Address
First Line	:	402 FOSTER AVE
Second Line	:	B8
City	:	BROOKLYN
State	:	NY
Zip	:	11230
Country	:	US
Telephone Number	:	718-633-5551
Fax Number	:	718-633-5551

Provider Business Practice Location Address
First Line	:	26 COURT STREET
Second Line	:	SUITE 1010
City	:	BROOKLYN
State	:	NY
Zip	:	11242
Country	:	US
Telephone Number	:	718-633-5551
Fax Number	:	718-633-5551

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	07/08/2007

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