Healthcare Provider Details

I. General information

NPI: 1578306205
Provider Name (Legal Business Name): REID BIRDOFF ALTMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2024
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 GREAT NECK RD STE 400N
GREAT NECK NY
11021-3326
US

IV. Provider business mailing address

185 GREAT NECK RD STE 400N
GREAT NECK NY
11021-3326
US

V. Phone/Fax

Practice location:
  • Phone: 914-582-4098
  • Fax:
Mailing address:
  • Phone: 914-582-4098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15329
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06506200
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number099445
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: