Healthcare Provider Details

I. General information

NPI: 1972329548
Provider Name (Legal Business Name): NACHMA TZIONA FAGIN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NACHMA TZIONA HIRSCH LMSW

II. Dates (important events)

Enumeration Date: 11/28/2024
Last Update Date: 11/28/2024
Certification Date: 11/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 FRANKLIN PL
WOODMERE NY
11598-1253
US

IV. Provider business mailing address

141 WYCKOFF PL APT 2A
WOODMERE NY
11598-2116
US

V. Phone/Fax

Practice location:
  • Phone: 516-374-3671
  • Fax:
Mailing address:
  • Phone: 516-602-8697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number125207
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: