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General NPI Number Information
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NPI Number | 1902017221
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Entity Type | Individual
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Provider Name | JODI S ZISSER LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1841 BROADWAY 4TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10023-7603
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Country | US
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Telephone | 718-757-5586
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Fax |
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Provider Business Mailing Address
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Address Line | 83 7TH AVE APT 3
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City | BROOKLYN
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State | NY
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Zip | 11217-3676
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Country | US
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Telephone | 917-771-9651
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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 | 074720-1
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License Number State | NY
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