| None | |
|
103 Executive Dr Ste 503 New Windsor NY 12553-5508 | |
| (914) 906-8919 | |
| (845) 567-1118 |
| Full Name | None |
|---|---|
| Speciality | Social Worker |
| Location | 103 Executive Dr Ste 503, New Windsor, New York |
| Authorized Official Name and Position | Joanne M Washington (PRESIDENT) |
| Authorized Official Contact | 9149068919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| None 367 New Windsor Hwy #215 New Windsor NY 12553 Ph: (914) 906-8919 | None 103 Executive Dr Ste 503 New Windsor NY 12553-5508 Ph: (914) 906-8919 |
| NPI Number | 1598061251 |
|---|---|
| Provider Enumeration Date | 01/28/2011 |
| Last Update Date | 06/03/2024 |
| Certification Date | 06/03/2024 |
| Medicare PECOS PAC ID | 7113172545 |
|---|---|
| Medicare Enrollment ID | O20130308000384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598061251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R070923 (New York) | Primary |
| Provider Name | Joanne Washington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063553204 PECOS PAC ID: 2466475355 Enrollment ID: I20060124000664 |
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