Provider Demographics
NPI:1558538629
Name:OPPENHEIM, JOSIE (MA, LP)
Entity Type:Individual
Prefix:MS
First Name:JOSIE
Middle Name:
Last Name:OPPENHEIM
Suffix:
Gender:F
Credentials:MA, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 BETHUNE ST
Mailing Address - Street 2:APT, A507
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-2010
Mailing Address - Country:US
Mailing Address - Phone:212-691-0473
Mailing Address - Fax:212-206-6578
Practice Address - Street 1:354 W 12TH ST
Practice Address - Street 2:APT, 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-1769
Practice Address - Country:US
Practice Address - Phone:212-206-6578
Practice Address - Fax:212-206-6578
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000491102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst