MEDICARE: OLIVIA GIEGERICH 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	104100000X	Social Worker	052990-1	NY

General Provider Information

NPI Number	:	1912440066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA GIEGERICH LCSW

Provider Business Mailing Address
First Line	:	330 W 58TH ST STE 313
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10019-1821
Country	:	US
Telephone Number	:	212-579-3639
Fax Number	:	212-368-5608

Provider Business Practice Location Address
First Line	:	330 W 58TH ST STE 313
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10019-1821
Country	:	US
Telephone Number	:	212-694-9200
Fax Number	:	212-368-5608

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

Provider Enumeration Date	:	11/22/2016
Last Update Date	:	01/06/2021

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