Provider Demographics
NPI:1225157076
Name:GAZARIK, RITA MAE (LCSWR)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:MAE
Last Name:GAZARIK
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 WEST END AVE
Mailing Address - Street 2:2H
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10024
Mailing Address - Country:US
Mailing Address - Phone:646-939-9661
Mailing Address - Fax:212-807-0706
Practice Address - Street 1:345 7TH AVE STE 1601
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5006
Practice Address - Country:US
Practice Address - Phone:212-727-1568
Practice Address - Fax:212-807-0706
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7402819OtherGHI
146204OtherVALUE OPTIONS
P1024163OtherPROVIDER OXFORD INSURANCE
P1024163OtherPROVIDER OXFORD INSURANCE