Healthcare Provider Details

I. General information

NPI: 1023006780
Provider Name (Legal Business Name): CHANA MALKA PFEIFER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 05/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 BERRYWOOD CT
WEST HEMPSTEAD NY
11552-2508
US

IV. Provider business mailing address

422 BERRYWOOD CT
WEST HEMPSTEAD NY
11552-2508
US

V. Phone/Fax

Practice location:
  • Phone: 516-592-1107
  • Fax: 516-833-5979
Mailing address:
  • Phone: 516-592-1107
  • Fax: 516-833-5979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR055811-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: