| Patricia Decesare Llc | |
|
19560 Club House Rd Montgomery Village MD 20886-3002 | |
| (240) 235-6560 | |
| Not Available |
| Full Name | Patricia Decesare Llc |
|---|---|
| Speciality | Social Worker |
| Location | 19560 Club House Rd, Montgomery Village, Maryland |
| Authorized Official Name and Position | Patricia Decesare (PRESIDENT) |
| Authorized Official Contact | 2402356560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patricia Decesare Llc 19560 Club House Rd Montgomery Village MD 20886-3002 Ph: (301) 366-0825 | Patricia Decesare Llc 19560 Club House Rd Montgomery Village MD 20886-3002 Ph: (240) 235-6560 |
| NPI Number | 1306254149 |
|---|---|
| Provider Enumeration Date | 07/24/2014 |
| Last Update Date | 07/19/2016 |
| Medicare PECOS PAC ID | 7517254915 |
|---|---|
| Medicare Enrollment ID | O20160929000030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306254149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Patricia C Decesare |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649385709 PECOS PAC ID: 4082705199 Enrollment ID: I20151116000188 |
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