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General NPI Number Information
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NPI Number | 1861990863
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Entity Type | Organization
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Legal Business Name | IHAB GIRGIS, PHD, LCSW, PLLC
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 01/25/2018
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Provider Practice Location Address
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Address Line | 107 NORTHERN BLVD STE 202
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City | GREAT NECK
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State | NY
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Zip | 11021-4309
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Country | US
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Telephone | 917-648-0885
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Fax |
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Provider Business Mailing Address
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Address Line | 210 INGRAHAM LN
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-4240
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Country | US
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Telephone | 917-648-0885
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. IHAB GIRGIS
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Credential | PHD, LCSWR
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Telephone | 917-648-0885
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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 | R075827
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License Number State | NY
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