MEDICARE: WENDY HAMILTON CHRISTIAN MSW, 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	082004-1	NY

General Provider Information

NPI Number	:	1912543216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY HAMILTON CHRISTIAN MSW, LCSW

Provider Business Mailing Address
First Line	:	16 PENN PLZ STE 1144
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-1809
Country	:	US
Telephone Number	:	917-991-6746
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 PENN PLZ STE 1144
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-1809
Country	:	US
Telephone Number	:	917-991-6746
Fax Number	:

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

Provider Enumeration Date	:	11/21/2019
Last Update Date	:	11/21/2019

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