Healthcare Provider Details

I. General information

NPI: 1154636215
Provider Name (Legal Business Name): CARY FRUMESS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2010
Last Update Date: 12/25/2023
Certification Date: 12/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108-37 71ST AVE. #9C
FOREST HILLS NY
11375
US

IV. Provider business mailing address

412 AVENUE OF THE AMERICAS STE. 702
NEW YORK NY
10011-8409
US

V. Phone/Fax

Practice location:
  • Phone: 718-275-2656
  • Fax:
Mailing address:
  • Phone: 212-627-4849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number041450
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: