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NPI Code Detail

MEDICARE: MATTHEW ELLIOT NITZBERG LMSW

MEDICARE:   MATTHEW ELLIOT NITZBERG  LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker129858NY

General Provider Information

NPI Number : 1669218194
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW ELLIOT NITZBERG LMSW
Provider Business Mailing Address
First Line : 1661 SUMMERFIELD ST APT PHE
Second Line :
City : RIDGEWOOD
State : NY
Zip : 11385-3384
Country : US
Telephone Number : 408-204-9531
Fax Number :
Provider Business Practice Location Address
First Line : 33 W 60TH ST FL 4
Second Line :
City : NEW YORK
State : NY
Zip : 10023-7905
Country : US
Telephone Number : 212-333-3444
Fax Number : 212-333-5444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2024
Last Update Date : 06/03/2026

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Directions to “ MATTHEW ELLIOT NITZBERG LMSW” Practice Location

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