Healthcare Provider Details

I. General information

NPI: 1164592838
Provider Name (Legal Business Name): WENDY BARBARA PLINER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 12/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10245 67TH RD APT 1T
FOREST HILLS NY
11375-2628
US

IV. Provider business mailing address

6419 FITCHETT ST
REGO PARK NY
11374-5050
US

V. Phone/Fax

Practice location:
  • Phone: 917-763-2284
  • Fax:
Mailing address:
  • Phone: 917-763-2284
  • Fax: 718-896-1851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR032198-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: