| Noderea John Lcsw Pllc | |
|
73 Market St Yonkers NY 10710-7616 | |
| (347) 742-5511 | |
| (914) 574-2017 |
| Full Name | Noderea John Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 73 Market St, Yonkers, New York |
| Authorized Official Name and Position | Noderea John (OWNER) |
| Authorized Official Contact | 3477425511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Noderea John Lcsw Pllc 3205 Hering Ave Bronx NY 10469-5003 Ph: (347) 742-5511 | Noderea John Lcsw Pllc 73 Market St Yonkers NY 10710-7616 Ph: (347) 742-5511 |
| NPI Number | 1992325260 |
|---|---|
| Provider Enumeration Date | 04/16/2020 |
| Last Update Date | 04/16/2020 |
| Certification Date | 04/16/2020 |
| Medicare PECOS PAC ID | 6800213661 |
|---|---|
| Medicare Enrollment ID | O20200826000289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992325260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Noderea John |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518365220 PECOS PAC ID: 2860740271 Enrollment ID: I20180801001943 |
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