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General NPI Number Information
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NPI Number | 1285272716
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Entity Type | Organization
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Legal Business Name | TAMAR IZCOVICH
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Dates
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Enumeration Date | 12/16/2019
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Last Update Date | 12/16/2019
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Provider Practice Location Address
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Address Line | 19 W 34TH ST PH
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City | NEW YORK
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State | NY
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Zip | 10001-3006
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Country | US
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Telephone | 516-784-7876
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Fax |
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Provider Business Mailing Address
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Address Line | 1912 3RD AVE APT 3A
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City | NEW YORK
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State | NY
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Zip | 10029-4618
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | TAMAR IZCOVICH
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Credential | LCSW
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Telephone | 929-239-4977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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