Provider Demographics
NPI:1629355433
Name:AJWANI, NEENA A (LMSW)
Entity Type:Individual
Prefix:
First Name:NEENA
Middle Name:A
Last Name:AJWANI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-3204
Mailing Address - Country:US
Mailing Address - Phone:718-320-4466
Mailing Address - Fax:718-991-3829
Practice Address - Street 1:60 MADISON AVE
Practice Address - Street 2:5TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-1600
Practice Address - Country:US
Practice Address - Phone:212-545-2400
Practice Address - Fax:646-312-0481
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079535104100000X
NY0803921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
WI331947Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
NY00695941Medicaid
WI331043Medicare Oscar/Certification
WI331009Medicare Oscar/Certification
WI331945Medicare Oscar/Certification
WI331943Medicare Oscar/Certification
WI331946Medicare Oscar/Certification
WI331978Medicare Oscar/Certification
WI331954Medicare Oscar/Certification
WI331944Medicare Oscar/Certification
WI331058Medicare Oscar/Certification
WI331952Medicare Oscar/Certification