Provider Demographics
NPI:1245773746
Name:DULCHIN & FADER, INC
Entity Type:Organization
Organization Name:DULCHIN & FADER, INC
Other - Org Name:UNION SQUARE PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:WINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-237-4125
Mailing Address - Street 1:817 BROADWAY
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4709
Mailing Address - Country:US
Mailing Address - Phone:212-335-2100
Mailing Address - Fax:646-790-2332
Practice Address - Street 1:817 BROADWAY
Practice Address - Street 2:10TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4709
Practice Address - Country:US
Practice Address - Phone:212-335-2100
Practice Address - Fax:646-790-2332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-01
Last Update Date:2017-07-18
Deactivation Date:2017-01-26
Deactivation Code:
Reactivation Date:2017-07-18
Provider Licenses
StateLicense IDTaxonomies
NY0950671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty