MEDICARE: MRS. MARGALIT R BEERY 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	073671	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922192384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARGALIT R BEERY LCSW

Provider Business Mailing Address
First Line	:	4 GREAT JONES ST
Second Line	:	5
City	:	NEW YORK
State	:	NY
Zip	:	10012-1134
Country	:	US
Telephone Number	:	212-777-0716
Fax Number	:	718-676-4216

Provider Business Practice Location Address
First Line	:	4 GREAT JONES ST
Second Line	:	5
City	:	NEW YORK
State	:	NY
Zip	:	10012-1134
Country	:	US
Telephone Number	:	212-777-0716
Fax Number	:	718-676-4216

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	07/08/2007

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