Marian Lee Myskowsky, LCSWR

Individual provider Active NPI Clinical Social Worker · Beechhurst, NY

NPI 1497962005 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1497962005
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
R038904-1 (NY)
Practice address
16625 Powells Cove Blvd
Suite 6G
Beechhurst, NY 11357-1545
Phone
(718) 767-8160
Fax
(631) 725-0072
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R038904-1NYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R038904-1 NY Yes

Addresses

Primary practice location

16625 Powells Cove Blvd
Suite 6G
Beechhurst, NY 11357-1545

Mailing address

16625 Powells Cove Blvd
Suite 6G
Beechhurst, NY 11357-1545
Phone (718) 767-8160

Other identifiers

IdentifierTypeStateIssuer
R0389041OtherNYLCSWR

Other providers in Beechhurst, NY

All providers in Beechhurst, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.