Provider Demographics
NPI:1093860926
Name:BAZES, DEBORAH REIDER (LCSW LP)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:REIDER
Last Name:BAZES
Suffix:
Gender:F
Credentials:LCSW LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 W 86TH ST
Mailing Address - Street 2:#1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024
Mailing Address - Country:US
Mailing Address - Phone:212-580-4707
Mailing Address - Fax:917-441-3553
Practice Address - Street 1:334 W 86TH ST
Practice Address - Street 2:#1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:212-580-4707
Practice Address - Fax:917-441-3553
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0431541041C0700X
NY000203102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst