Healthcare Provider Details

I. General information

NPI: 1659388452
Provider Name (Legal Business Name): LESLIE EPSTEIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 BROADWAY NEW GREENWICH ASSOCIATES, 9TH FLOOR
NEW YORK NY
10003-4709
US

IV. Provider business mailing address

817 BROADWAY NEW GREENWICH ASSOCIATES, 9TH FLOOR
NEW YORK NY
10003-4709
US

V. Phone/Fax

Practice location:
  • Phone: 917-482-2272
  • Fax:
Mailing address:
  • Phone: 917-482-2272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR048305-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: