Healthcare Provider Details

I. General information

NPI: 1972814168
Provider Name (Legal Business Name): JOANNE VOSKO ZUCKERMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 W 11TH ST
NEW YORK NY
10011-8778
US

IV. Provider business mailing address

44 W 11TH ST
NEW YORK NY
10011-8778
US

V. Phone/Fax

Practice location:
  • Phone: 212-752-4553
  • Fax: 212-752-4553
Mailing address:
  • Phone: 212-752-4553
  • Fax: 212-752-4553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberR014897-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR014897-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: