Provider Demographics
NPI:1629464888
Name:MANKOFF, MILTON LAWRENCE (LMSW, PHD, MSW)
Entity Type:Individual
Prefix:MR
First Name:MILTON
Middle Name:LAWRENCE
Last Name:MANKOFF
Suffix:
Gender:M
Credentials:LMSW, PHD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:788 COLUMBUS AVE APT 11P
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5942
Mailing Address - Country:US
Mailing Address - Phone:212-662-4199
Mailing Address - Fax:
Practice Address - Street 1:788 COLUMBUS AVE APT 11P
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5942
Practice Address - Country:US
Practice Address - Phone:212-662-4199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043110-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical