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General NPI Number Information
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NPI Number | 1376765230
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Entity Type | Individual
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Provider Name | RANDY CAROL FAERBER L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 01/20/2017
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Provider Practice Location Address
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Address Line | 205 EAST 69TH STREET
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City | NEW YORK
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State | NY
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Zip | 10021-5437
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Country | US
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Telephone | 917-848-4065
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Fax | 212-986-0997
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Provider Business Mailing Address
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Address Line | 300 EAST 71ST STREET
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City | NEW YORK
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State | NY
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Zip | 10021
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Country | US
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Telephone | 212-972-9884
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Fax | 212-986-0997
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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 | R032810
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License Number State | NY
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