Provider Demographics
NPI:1437571916
Name:KRUPKIN, MARISHA ELLEN (MSW)
Entity Type:Individual
Prefix:
First Name:MARISHA
Middle Name:ELLEN
Last Name:KRUPKIN
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 1:37 WEST 57TH STREET - SUITE 601
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019
Mailing Address - Country:US
Mailing Address - Phone:646-382-6011
Mailing Address - Fax:212-988-2146
Practice Address - Street 1:37 W 57TH ST STE 601
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3476
Practice Address - Country:US
Practice Address - Phone:646-382-6011
Practice Address - Fax:212-988-2146
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0788231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical