Healthcare Provider Details

I. General information

NPI: 1255523163
Provider Name (Legal Business Name): VIVIAN L. ESKIN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 05/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

666 WEST END AVE SUITE 1C
NEW YORK NY
10024
US

IV. Provider business mailing address

666 WEST END AVE SUITE 1C
NEW YORK NY
10024
US

V. Phone/Fax

Practice location:
  • Phone: 212-724-4785
  • Fax:
Mailing address:
  • Phone: 212-724-4785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0383721
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: