Healthcare Provider Details

I. General information

NPI: 1659409779
Provider Name (Legal Business Name): JOAN A GELFMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 FRANKLIN PLACE
WOODMERE NY
11598
US

IV. Provider business mailing address

301 MERRICK AVE
EAST MEADOW NY
11554
US

V. Phone/Fax

Practice location:
  • Phone: 516-569-7890
  • Fax: 516-374-2132
Mailing address:
  • Phone: 516-794-5594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberRO412631
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: