Provider Demographics
NPI:1427207885
Name:POMERANTZ, ALEXANDRA K (MSW)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:K
Last Name:POMERANTZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 JOHN ST
Mailing Address - Street 2:27 FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-3300
Mailing Address - Country:US
Mailing Address - Phone:212-385-0085
Mailing Address - Fax:212-732-0757
Practice Address - Street 1:116 JOHN ST
Practice Address - Street 2:27 FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-3300
Practice Address - Country:US
Practice Address - Phone:212-385-0085
Practice Address - Fax:212-732-0757
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPENDING1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133480517OtherWORKS FOR CIS COUNSELING CENTER INC.