Facts
- Status
- A
- Credential
- Certified Social Wor
- Type
- Individual
- Enumeration date
- 2007-01-22
- Last updated
- 2007-07-08
Licenses
- License NY
- 36219
- License NJ
- 44SW00118000
Location
- Practice location
- 240 FIRST AVENUE, APT 10G
- City
- NYC NY
- Postal code
- 100092605
- Phone
- 212-260-5997
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
Search this city from the state hub for other records in the public registry.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.