Individual ProviderCarol PavinSocial WorkerBehavioral Health & Social Service ProvidersPractice Address1260 Richmond Rd, Staten Island, NY 10304-2304(718) 667-1416(718) 987-8521PECOS EnrollmentBased on the most recent information from CMS, provider Carol Pavin is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1588696124Provider TypeIndividualFull NamePavin, CarolTitleMs.CredentialLCSWGenderFemaleSole ProprietorYesEnumeration Date7/6/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address1260 Richmond Rd, Staten Island, NY 10304-2304Phone(718) 667-1416Fax(718) 983-0348Mailing LocationMailing Address100 Colfax Ave, Staten Island, NY 10306-3306Phone(718) 987-8521Fax(718) 983-0348Provider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseR058729-1New YorkProvider IdentifiersIDDescriptionIssuerID554982DescriptionOtherIssuerVALUE OPTIONNew YorkIDP2367187DescriptionOtherIssuerOXFORDNew York