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Organization
MD CONSULTATION LCSW PC
Active
Organization
MD CONSULTATION LCSW PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRNA DIPTEE LCSW (PRESIDENT)
(718) 310-0598
Entity
Organization
Contact information
Practice address
3457 82ND ST, JACKSON HEIGHTS, NY 11372-2939
(718) 310-0598
Mailing address
3457 82ND ST, JACKSON HEIGHTS, NY 11372-2939
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
071211
NY
Other
Enumeration date
02/11/2015
Last updated
05/01/2015
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