Provider Demographics
NPI:1326115874
Name:LEBOWITZ, WENDY ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:ANN
Last Name:LEBOWITZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 HICKS ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4508
Mailing Address - Country:US
Mailing Address - Phone:718-643-1984
Mailing Address - Fax:718-722-7560
Practice Address - Street 1:315 HICKS ST
Practice Address - Street 2:GARDEN FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4508
Practice Address - Country:US
Practice Address - Phone:917-865-1890
Practice Address - Fax:718-722-7560
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009719-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical