MEDICARE: MS. HARRIET RZETELNY 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	LCSWR018545	NY

General Provider Information

NPI Number	:	1972536753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HARRIET RZETELNY LCSW

Provider Business Mailing Address
First Line	:	59 MAIN ST
Second Line	:	APT. 44-2
City	:	DENNIS
State	:	MA
Zip	:	02638-1938
Country	:	US
Telephone Number	:	508-385-2532
Fax Number	:	508-385-2241

Provider Business Practice Location Address
First Line	:	156 5TH AVE
Second Line	:	SUITE 508
City	:	NEW YORK
State	:	NY
Zip	:	10010-7002
Country	:	US
Telephone Number	:	212-647-0745
Fax Number	:

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

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

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