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General NPI Number Information
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NPI Number | 1255609145
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Entity Type | Individual
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Provider Name | PETER WILLIAM PRZERADZKI DSW, LCSW-R
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Gender | Male
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Dates
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Enumeration Date | 12/06/2011
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 777 SEAVIEW AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3409
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Country | US
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Telephone | 187-668-8050
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Fax | 187-668-8010
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Provider Business Mailing Address
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Address Line | 7701 13TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11228-2413
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Country | US
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Telephone | 718-232-1351
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Fax | 718-837-5676
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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 | 080334
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License Number State | NY
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