Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 074783-1 | NY |
NPI | 1003187253 |
---|---|
Provider Name | Mr. Asher Simcha Lebowitz |
First Address | Far Rockaway, NY 11691-5636 |
Second Address | Far Rockaway, NY 11691-5636 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2012 |
Last Update Date | 19/01/2012 |