Healthcare Provider Details

I. General information

NPI: 1417478470
Provider Name (Legal Business Name): TEMIMAH ZUCKER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 W 19TH ST STE 413
NEW YORK NY
10011-4333
US

IV. Provider business mailing address

33 W 19TH ST STE 413
NEW YORK NY
10011-4333
US

V. Phone/Fax

Practice location:
  • Phone: 201-312-7669
  • Fax:
Mailing address:
  • Phone: 201-312-7669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number096266
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: