Provider Demographics
NPI:1578764825
Name:BLUMENKRANTZ, CHARNA (MS, MFA)
Entity Type:Individual
Prefix:MRS
First Name:CHARNA
Middle Name:
Last Name:BLUMENKRANTZ
Suffix:
Gender:F
Credentials:MS, MFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 DE KOVEN CT
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-1744
Mailing Address - Country:US
Mailing Address - Phone:917-880-5851
Mailing Address - Fax:
Practice Address - Street 1:52 DE KOVEN CT
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-1744
Practice Address - Country:US
Practice Address - Phone:917-880-5851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000253102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst