Provider Demographics
NPI:1457645681
Name:KERZNER, SHIRA MIRIAM (LMSW)
Entity Type:Individual
Prefix:MS
First Name:SHIRA
Middle Name:MIRIAM
Last Name:KERZNER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 W 36TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-7598
Mailing Address - Country:US
Mailing Address - Phone:212-560-6784
Mailing Address - Fax:
Practice Address - Street 1:344 W 36TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-7598
Practice Address - Country:US
Practice Address - Phone:212-560-6784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72082116104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker