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General NPI Number Information
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NPI Number | 1437203015
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Entity Type | Individual
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Provider Name | MRS. YEKATERINA CHIZHOVA
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 145 MAIN ST
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City | HACKENSACK
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State | NJ
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Zip | 07601-8107
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Country | US
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Telephone | 201-488-5161
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Fax | 201-488-5162
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Provider Business Mailing Address
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Address Line | 70 WILLOW LN
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City | TENAFLY
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State | NJ
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Zip | 07670-2808
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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 |
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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 | 44SC05236100
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License Number State | NJ
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