| Joanna Bogdan-fyles, Lcsw, Pllc | |
|
600 E Genesee St Suite 228 Syracuse NY 13202-3130 | |
| (315) 234-0213 | |
| (315) 234-0214 |
| Full Name | Joanna Bogdan-fyles, Lcsw, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 600 E Genesee St, Syracuse, New York |
| Authorized Official Name and Position | Joanna Paula Bogdan-fyles (OWNER) |
| Authorized Official Contact | 3152340213 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joanna Bogdan-fyles, Lcsw, Pllc 600 E Genesee St Suite 228 Syracuse NY 13202-3130 Ph: (315) 234-0213 | Joanna Bogdan-fyles, Lcsw, Pllc 600 E Genesee St Suite 228 Syracuse NY 13202-3130 Ph: (315) 234-0213 |
| NPI Number | 1790972107 |
|---|---|
| Provider Enumeration Date | 09/29/2007 |
| Last Update Date | 09/29/2007 |
| Medicare PECOS PAC ID | 8426010422 |
|---|---|
| Medicare Enrollment ID | O20041102000420 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790972107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R034387-1 (New York) | Primary |
| Provider Name | Joanna P Bogdan Fyles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811002405 PECOS PAC ID: 2062474075 Enrollment ID: I20041103000764 |
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