Healthcare Provider Details

I. General information

NPI: 1659702074
Provider Name (Legal Business Name): NAOMI DWECK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 12/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 W 50TH ST 6 FL
NEW YORK NY
10020-1201
US

IV. Provider business mailing address

135 W 50TH ST 6 FL
NEW YORK NY
10020-1201
US

V. Phone/Fax

Practice location:
  • Phone: 212-632-4761
  • Fax:
Mailing address:
  • Phone: 212-632-4761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number088487
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: