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NPI Code Detail

MEDICARE: DENA PRYBUTOK L.C.S.W.

MEDICARE:   DENA  PRYBUTOK  L.C.S.W.
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
11041C0700XClinical Social WorkerR0692281-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1R0692281-1OTHERNYLICENSE NUMBER
2P3602059OTHERNYOXFORD HEALTH INSURANCE

General Provider Information

NPI Number : 1750508354
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENA PRYBUTOK L.C.S.W.
Provider Business Mailing Address
First Line : 140 E 56TH ST
Second Line : APT. 6D
City : NEW YORK
State : NY
Zip : 10022-3623
Country : US
Telephone Number : 646-221-7873
Fax Number : 516-759-9883
Provider Business Practice Location Address
First Line : 32 UNION SQ E
Second Line : SUITE 805
City : NEW YORK
State : NY
Zip : 10003-3209
Country : US
Telephone Number : 646-221-7873
Fax Number : 516-759-9883
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 07/08/2007

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Directions to “ DENA PRYBUTOK L.C.S.W.” Practice Location

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