1538224431 NPI number — MRS. BARBARA LYNN GEWIRTZ LCSW

Table of content: MRS. BARBARA LYNN GEWIRTZ LCSW (NPI 1538224431)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538224431 NPI number — MRS. BARBARA LYNN GEWIRTZ LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEWIRTZ
Provider First Name:
BARBARA
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538224431
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
52 GREENACRES AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCARSDALE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10583-1436
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-472-2328
Provider Business Mailing Address Fax Number:
914-722-5975

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14 RYE RIDGE PLZ
Provider Second Line Business Practice Location Address:
SUITE 228
Provider Business Practice Location Address City Name:
RYE BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10573-2826
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-253-9190
Provider Business Practice Location Address Fax Number:
914-253-9192
Provider Enumeration Date:
12/22/2006

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:  R 170947 , 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)

  • Identifier: 02261109 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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