Provider Demographics
NPI:1558078931
Name:SENDROW, MICHAEL (LP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:SENDROW
Suffix:
Gender:M
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1286 PROSPECT AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-1304
Mailing Address - Country:US
Mailing Address - Phone:646-675-6222
Mailing Address - Fax:
Practice Address - Street 1:26 W 9TH ST APT 3D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8923
Practice Address - Country:US
Practice Address - Phone:646-675-6222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001158102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst