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General NPI Number Information
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NPI Number | 1700651676
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Entity Type | Individual
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Provider Name | DEBRA ITZKOWITZ LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 13523 78TH RD
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City | FLUSHING
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State | NY
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Zip | 11367-3239
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Country | US
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Telephone | 201-688-0722
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Fax |
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Provider Business Mailing Address
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Address Line | 1 GISELE CT
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City | SUFFERN
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State | NY
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Zip | 10901-3327
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Country | US
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Telephone | 502-512-8273
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL06823000
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License Number State | NJ
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