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General NPI Number Information
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NPI Number | 1255459822
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Entity Type | Organization
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Legal Business Name | LEO STOROZUM PHD ET AL PTR FAMILY COUNSELING SERVICE
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 205 EAST 17TH STREET
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City | NEW YORK
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State | NY
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Zip | 10003-3619
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Country | US
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Telephone | 212-674-8516
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Fax |
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Provider Business Mailing Address
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Address Line | 205 EAST 17TH STREET
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City | NEW YORK
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State | NY
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Zip | 10003-3619
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Country | US
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Telephone | 212-674-8516
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Fax | 212-253-9289
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Authorized Official
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Title or Position | COORDINATOR
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Name | DR. LEO STOROZUM
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Credential | PHD
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Telephone | 212-674-8516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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