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General NPI Number Information
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NPI Number | 1457626020
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Entity Type | Individual
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Provider Name | ELIOT LEBOW L.C.S.W., C.D.E.
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Gender | Male
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Dates
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Enumeration Date | 03/15/2012
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 323 W 96TH ST SUITE 2
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City | NEW YORK
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State | NY
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Zip | 10025-6191
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Country | US
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Telephone | 917-272-4829
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Fax |
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Provider Business Mailing Address
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Address Line | 323 W 96TH ST SUITE 2
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City | NEW YORK
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State | NY
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Zip | 10025-6191
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Country | US
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Telephone | 917-272-4829
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number | 21320600
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 078246
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License Number State | NY
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