Healthcare Provider Details

I. General information

NPI: 1922174853
Provider Name (Legal Business Name): SHANI DALIA ZYLBERMAN LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 05/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 W. 35TH ST 7TH FLOOR
NEW YORK NY
10001
US

IV. Provider business mailing address

2373 BROADWAY APT # 504
NEW YORK NY
10024
US

V. Phone/Fax

Practice location:
  • Phone: 847-924-7212
  • Fax:
Mailing address:
  • Phone: 847-924-7212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: