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General NPI Number Information
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NPI Number | 1831633585
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Entity Type | Organization
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Legal Business Name | BAY RIDGE LCSW PLLC
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Dates
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Enumeration Date | 12/15/2016
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Last Update Date | 04/19/2025
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Provider Practice Location Address
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Address Line | 4056 AMBOY RD
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City | STATEN ISLAND
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State | NY
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Zip | 10308-2409
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Country | US
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Telephone | 718-808-5708
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 80315
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City | STATEN ISLAND
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State | NY
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Zip | 10308-0315
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Country | US
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Telephone | 718-808-5708
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALIZA SKAYA
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Credential | LCSW
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Telephone | 718-808-5708
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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 | 0823451
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License Number State | NY
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