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General NPI Number Information
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NPI Number | 1184643637
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Entity Type | Individual
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Provider Name | AMY M WIEST-D'ANNA LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 05/06/2009
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Provider Practice Location Address
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Address Line | 175 W 79TH ST STE 1A
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City | NEW YORK
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State | NY
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Zip | 10024-6450
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Country | US
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Telephone | 212-414-5328
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Fax | 212-580-9418
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Provider Business Mailing Address
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Address Line | 304 W 75TH ST 8H
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City | NEW YORK
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State | NY
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Zip | 10023-1689
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Country | US
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Telephone | 212-496-0873
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Fax | 212-580-9418
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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 | 072227
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License Number State | NY
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