Provider Demographics
NPI:1376580878
Name:NAYOR, SUSAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:NAYOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 RIVERSIDE DR
Mailing Address - Street 2:APT# 12TW
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2504
Mailing Address - Country:US
Mailing Address - Phone:212-501-0210
Mailing Address - Fax:212-769-1007
Practice Address - Street 1:120 E 36TH ST
Practice Address - Street 2:APT 1H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3465
Practice Address - Country:US
Practice Address - Phone:212-501-0210
Practice Address - Fax:212-769-1007
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO45769-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN1H741Medicare ID - Type Unspecified