Provider Demographics
NPI:1558144188
Name:GOMORY-PINK, ANIKO NATANIA (LMSW)
Entity Type:Individual
Prefix:
First Name:ANIKO
Middle Name:NATANIA
Last Name:GOMORY-PINK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ANIKO
Other - Middle Name:NATANIA
Other - Last Name:GOMORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:145 W 96TH ST # 6F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:541 BAY RIDGE PKWY UNIT LL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3309
Practice Address - Country:US
Practice Address - Phone:929-224-2142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120485-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical