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General NPI Number Information
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NPI Number | 1033367404
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Entity Type | Individual
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Provider Name | STEVEN FRESSOLA LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 200 E 30TH ST 16H
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City | NEW YORK
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State | NY
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Zip | 10016-8280
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Country | US
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Telephone | 646-221-4651
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Fax | 212-547-8454
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Provider Business Mailing Address
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Address Line | 258 W 22ND ST 4 G
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City | NEW YORK
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State | NY
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Zip | 10011-2703
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Country | US
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Telephone | 646-221-4651
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Fax | 212-547-8454
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 05735
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License Number State | NY
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