Basic Information
| Provider Information | |||||||||
| NPI: | 1457696643 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANDREWS-WECKERLY | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | JEFFREY | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 162-21 JAMAICA AVE. | ||||||||
| Address2: | SIXTH FLOOR | ||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188962500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 16221 JAMAICA AVE | ||||||||
| Address2: | SIXTH FLOOR | ||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114324909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188962500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2012 | ||||||||
| LastUpdateDate: | 11/29/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 088147 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.