Healthcare Provider Details

I. General information

NPI: 1598524902
Provider Name (Legal Business Name): HELEN D KAZINETS-SMORODIN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 03/18/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 KINGS HIGHWAY
BROOKLYN NY
11229
US

IV. Provider business mailing address

1623 KINGS HIGHWAY
BROOKLYN NY
11229
US

V. Phone/Fax

Practice location:
  • Phone: 929-273-7601
  • Fax: 718-307-6871
Mailing address:
  • Phone: 929-273-7601
  • Fax: 718-307-6871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number054450
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: