Provider Demographics
NPI:1033682869
Name:WEXLER, ELIZABETH KADEE
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:KADEE
Last Name:WEXLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 HAMMOND RD
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-2851
Mailing Address - Country:US
Mailing Address - Phone:631-682-8837
Mailing Address - Fax:
Practice Address - Street 1:112 HAMMOND RD
Practice Address - Street 2:
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-2851
Practice Address - Country:US
Practice Address - Phone:631-682-8837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091022104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker