Provider Demographics
NPI:1356464390
Name:BIRNBAUM, JACQUELINE CLAIRE (LCAT)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:CLAIRE
Last Name:BIRNBAUM
Suffix:
Gender:F
Credentials:LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:311 BRONXVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-2111
Mailing Address - Country:US
Mailing Address - Phone:914-961-6953
Mailing Address - Fax:212-995-4045
Practice Address - Street 1:82 WASHINGTON SQ E FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6680
Practice Address - Country:US
Practice Address - Phone:212-998-5162
Practice Address - Fax:212-995-4045
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000286225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist