1417044835 NPI number — JOAN J TURNER MSW LCSW

Table of content: JOAN J TURNER MSW LCSW (NPI 1417044835)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417044835 NPI number — JOAN J TURNER MSW LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TURNER
Provider First Name:
JOAN
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417044835
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
31-85 CRESCENT STREET
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
ASTORIA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11106-3702
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-204-4896
Provider Business Mailing Address Fax Number:
718-278-9620

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
31-85 CRESCENT STREET
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
ASTORIA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11106-3702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-204-4896
Provider Business Practice Location Address Fax Number:
718-278-9620
Provider Enumeration Date:
10/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  RP022761 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01812564 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: R022761N01 . This is a "HIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: P480804 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7480942 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 117802 . This is a "VO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 13722400 . This is a "MBC" identifier . This identifiers is of the category "OTHER".




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