Healthcare Provider Details

I. General information

NPI: 1558582601
Provider Name (Legal Business Name): HELAINE CIPOREN L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

782 W END AVE #83
NEW YORK NY
10025-5446
US

IV. Provider business mailing address

782 W END AVE #83
NEW YORK NY
10025-5446
US

V. Phone/Fax

Practice location:
  • Phone: 212-316-1972
  • Fax:
Mailing address:
  • Phone: 212-316-1972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberR045973
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: