Provider Demographics
NPI:1376894311
Name:KREFSKY, FLORRI J
Entity Type:Individual
Prefix:
First Name:FLORRI
Middle Name:J
Last Name:KREFSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 S ALLEGHANY AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-5112
Mailing Address - Country:US
Mailing Address - Phone:631-867-3200
Mailing Address - Fax:
Practice Address - Street 1:250 S ALLEGHANY AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-5112
Practice Address - Country:US
Practice Address - Phone:631-867-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730586881041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool