Provider Demographics
NPI:1033882139
Name:KIRZHNER, IVA Y
Entity Type:Individual
Prefix:MRS
First Name:IVA
Middle Name:Y
Last Name:KIRZHNER
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 1:92 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-1540
Mailing Address - Country:US
Mailing Address - Phone:917-742-5312
Mailing Address - Fax:
Practice Address - Street 1:25 TERRELL RD
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08530-3428
Practice Address - Country:US
Practice Address - Phone:917-742-5312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-26
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical