Healthcare Provider Details

I. General information

NPI: 1225256100
Provider Name (Legal Business Name): VICTORIA M. WURMAN L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

337 BLEECKER ST APT. 1
NEW YORK NY
10014-2979
US

IV. Provider business mailing address

337 BLEECKER ST APT. 1
NEW YORK NY
10014-2979
US

V. Phone/Fax

Practice location:
  • Phone: 212-929-8927
  • Fax:
Mailing address:
  • Phone: 212-929-8927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR017479
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: