Healthcare Provider Details

I. General information

NPI: 1720124126
Provider Name (Legal Business Name): MARIA I CIPRIANI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 02/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 W 34TH ST PENTHOUSE
NEW YORK NY
10001-3006
US

IV. Provider business mailing address

PO BOX 265
KINGS PARK NY
11754-0265
US

V. Phone/Fax

Practice location:
  • Phone: 212-594-4659
  • Fax:
Mailing address:
  • Phone: 212-594-4659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR060492-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: