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General NPI Number Information
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NPI Number | 1275633380
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Entity Type | Individual
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Provider Name | ELENA LEVENTAL LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 31 W 9TH ST SUITE 1F
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City | NEW YORK
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State | NY
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Zip | 10011-9206
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Country | US
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Telephone | 201-794-6459
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Fax |
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Provider Business Mailing Address
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Address Line | 12-55 12TH ST
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City | FAIR LAWN
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State | NJ
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Zip | 07410-2201
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Country | US
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Telephone | 201-794-6459
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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 | 069908
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License Number State | NY
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