| Bay Ridge Lcsw Pllc | |
|
4056 Amboy Rd Staten Island NY 10308-2409 | |
| (718) 808-5708 | |
| Not Available |
| Full Name | Bay Ridge Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 4056 Amboy Rd, Staten Island, New York |
| Authorized Official Name and Position | Aliza Skaya (OWNER) |
| Authorized Official Contact | 7188085708 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay Ridge Lcsw Pllc Po Box 80315 Staten Island NY 10308-0315 Ph: (718) 808-5708 | Bay Ridge Lcsw Pllc 4056 Amboy Rd Staten Island NY 10308-2409 Ph: (718) 808-5708 |
| NPI Number | 1831633585 |
|---|---|
| Provider Enumeration Date | 12/15/2016 |
| Last Update Date | 04/19/2025 |
| Certification Date | 04/19/2025 |
| Medicare PECOS PAC ID | 9830473677 |
|---|---|
| Medicare Enrollment ID | O20170223000439 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831633585 | NPI | - | NPPES |
| A300130327 | Other | NY | MEDICARE PTAN |
| 03430320 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0823451 (New York) | Primary |
| Provider Name | Aliza Skaya |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972881522 PECOS PAC ID: 6507181716 Enrollment ID: I20150211000482 |
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