Healthcare Provider Details

I. General information

NPI: 1013842897
Provider Name (Legal Business Name): ELAINE GOTTESMAN KATZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELAINE GOTTESMAN LCSW

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 E 86TH ST
NEW YORK NY
10028-1024
US

IV. Provider business mailing address

108 E 86TH ST
NEW YORK NY
10028-1024
US

V. Phone/Fax

Practice location:
  • Phone: 201-663-5213
  • Fax:
Mailing address:
  • Phone: 201-663-5213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number095864
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: