Healthcare Provider Details

I. General information

NPI: 1689731333
Provider Name (Legal Business Name): NAFTOLI Y. WALFISH LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: NEIL WALFISH

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 MAIN AVE
PASSAIC NJ
07055-5742
US

IV. Provider business mailing address

258 MAIN AVE
PASSAIC NJ
07055-5742
US

V. Phone/Fax

Practice location:
  • Phone: 201-614-4004
  • Fax: 973-777-3424
Mailing address:
  • Phone: 201-614-4004
  • Fax: 973-777-3424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number059 899
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44 SC 052 76 500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: