Provider Demographics
NPI:1598972739
Name:CHRISTIAN, ETHEL M (MSW)
Entity Type:Individual
Prefix:MS
First Name:ETHEL
Middle Name:M
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1242
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10150
Mailing Address - Country:US
Mailing Address - Phone:212-688-2486
Mailing Address - Fax:
Practice Address - Street 1:400 E 55TH STREET
Practice Address - Street 2:SUITE 11-G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5156
Practice Address - Country:US
Practice Address - Phone:212-688-2486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR00657511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical