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General NPI Number Information
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NPI Number | 1205961265
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Entity Type | Individual
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Provider Name | MIRIAM ROSE DENMARK LMSW
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/08/2013
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Provider Practice Location Address
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Address Line | 130 W 97TH ST
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City | NEW YORK
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State | NY
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Zip | 10025-6450
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Country | US
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Telephone | 303-960-7698
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Fax |
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Provider Business Mailing Address
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Address Line | 160 W 118TH ST APT 2B
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City | NEW YORK
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State | NY
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Zip | 10026-1824
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Country | US
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Telephone | 303-504-1846
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Fax | 303-894-8107
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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 | 083954
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License Number State | NY
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