Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 085525 | NY |
NPI | 1003209321 |
---|---|
Provider Name | Jessica Faye Oppenheimer |
First Address | New York, NY 10022-5134 |
Second Address | New York, NY 10001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2015 |
Last Update Date | 22/01/2019 |