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General NPI Number Information
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NPI Number | 1477960805
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Entity Type | Individual
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Provider Name | CYRUS POLIAKOFF LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/17/2014
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 276 5TH AVENUE STE 507, OFFICE 4
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City | NEW YORK
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State | NY
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Zip | 10001
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Country | US
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Telephone | 917-342-2149
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Fax |
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Provider Business Mailing Address
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Address Line | 257 POWERS ST FL 1
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City | BROOKLYN
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State | NY
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Zip | 11211-5035
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Country | US
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Telephone | 650-815-9334
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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 | 087936-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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