1972724409 NPI number — MRS. NOBUKO YOSHIZAWA MEADERS MSSW LCSW

Table of content: MRS. NOBUKO YOSHIZAWA MEADERS MSSW LCSW (NPI 1972724409)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972724409 NPI number — MRS. NOBUKO YOSHIZAWA MEADERS MSSW LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEADERS
Provider First Name:
NOBUKO
Provider Middle Name:
YOSHIZAWA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSSW LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MEADERS
Provider Other First Name:
NOBUKO
Provider Other Middle Name:
TSUCHIYA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1972724409
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21 EAST 10TH STREET
Provider Second Line Business Mailing Address:
APT. # 3A
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-228-6988
Provider Business Mailing Address Fax Number:
212-473-8271

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21 EAST 10TH STREET
Provider Second Line Business Practice Location Address:
APT. # 3A
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-228-6988
Provider Business Practice Location Address Fax Number:
212-473-8271
Provider Enumeration Date:
05/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  PRO 144251 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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