Provider Demographics
NPI:1306200191
Name:SCHARF, SUSAN (MSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:SCHARF
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 QUARRY LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10506-1539
Mailing Address - Country:US
Mailing Address - Phone:917-587-0289
Mailing Address - Fax:
Practice Address - Street 1:65 MAIN STREET
Practice Address - Street 2:ANDRUS EARLY LEARNING CENTER,
Practice Address - City:TUCKAHOE
Practice Address - State:NY
Practice Address - Zip Code:10707
Practice Address - Country:US
Practice Address - Phone:914-337-4492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056328-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1285628552OtherAGENCIES
NYWVE061OtherMEDICARE #
NY00355940Medicaid