Provider Demographics
NPI:1023006780
Name:PFEIFER, CHANA MALKA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHANA
Middle Name:MALKA
Last Name:PFEIFER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 BERRYWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2508
Mailing Address - Country:US
Mailing Address - Phone:516-592-1107
Mailing Address - Fax:516-833-5979
Practice Address - Street 1:422 BERRYWOOD CT
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2508
Practice Address - Country:US
Practice Address - Phone:516-592-1107
Practice Address - Fax:516-833-5979
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR055811-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN5J271Medicare ID - Type Unspecified