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General NPI Number Information
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NPI Number | 1790724425
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Entity Type | Individual
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Provider Name | ROBERT M FEFERMAN
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6209 16TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11204-2702
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Country | US
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Telephone | 718-234-0073
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Fax | 718-236-8456
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Provider Business Mailing Address
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Address Line | 170 W END AVE
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City | NEW YORK
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State | NY
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Zip | 10023-5401
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Country | US
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Telephone | 212-595-1861
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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 | 72064967
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License Number State | NY
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