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General NPI Number Information
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NPI Number | 1164070587
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Entity Type | Individual
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Provider Name | TRACI BLAKE SALAMI LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 100 WILLIAM ST FL 6
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City | NEW YORK
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State | NY
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Zip | 10038-5039
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Country | US
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Telephone | 212-417-3876
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Fax | 212-417-3890
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Provider Business Mailing Address
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Address Line | 65 BELMONT AVE APT 2
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City | JERSEY CITY
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State | NJ
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Zip | 07304-3030
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Country | US
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Telephone | 917-837-6178
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 107157
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License Number State | NY
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