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General NPI Number Information
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NPI Number | 1912630872
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Entity Type | Individual
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Provider Name | TORI MAIDENBERG LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/07/2022
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Last Update Date | 07/07/2022
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Provider Practice Location Address
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Address Line | 200 W 57TH ST STE 1008
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City | NEW YORK
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State | NY
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Zip | 10019-3237
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Country | US
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Telephone | 646-837-5557
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Fax |
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Provider Business Mailing Address
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Address Line | 180 W END AVE APT 4F
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City | NEW YORK
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State | NY
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Zip | 10023-4913
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Country | US
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Telephone | 713-562-4150
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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 | 116506
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License Number State | NY
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