Provider Demographics
NPI:1659708667
Name:BRAVERMAN, ALLISON AMY
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:AMY
Last Name:BRAVERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 BURNETT ST
Mailing Address - Street 2:APT 3F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5849
Mailing Address - Country:US
Mailing Address - Phone:718-309-3579
Mailing Address - Fax:
Practice Address - Street 1:135 W 50TH ST
Practice Address - Street 2:6 FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10020-1201
Practice Address - Country:US
Practice Address - Phone:212-632-4762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-04
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01880051Medicaid