Provider Demographics
NPI:1073673786
Name:DREIBLATT, ALAN (MSW)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:DREIBLATT
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WIMBLETON LN
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1348
Mailing Address - Country:US
Mailing Address - Phone:516-487-2035
Mailing Address - Fax:516-487-2035
Practice Address - Street 1:25 WIMBLETON LN
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-1348
Practice Address - Country:US
Practice Address - Phone:516-487-2035
Practice Address - Fax:516-487-2035
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02072911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical