Provider Demographics
NPI:1154455509
Name:KOVAL, NINA (MSW)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:KOVAL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10470 QUEENS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3694
Mailing Address - Country:US
Mailing Address - Phone:718-275-6010
Mailing Address - Fax:
Practice Address - Street 1:97-45 QUEENS BLV.
Practice Address - Street 2:PH FLOOR
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-896-9090
Practice Address - Fax:718-830-0724
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP09597104100000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker