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General NPI Number Information
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NPI Number | 1083727614
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Entity Type | Individual
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Provider Name | NINA SMUKLAVSKAYA LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2327 83RD ST STE D
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City | BROOKLYN
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State | NY
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Zip | 11214-2749
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Country | US
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Telephone | 732-236-0700
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Fax | 732-232-2526
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Provider Business Mailing Address
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Address Line | 11 ISABEL CT
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City | MORGANVILLE
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State | NJ
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Zip | 07751-2227
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Country | US
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Telephone | 732-617-1087
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Fax | 732-617-0652
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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 | 5458360
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License Number State | NY
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