Provider Demographics
NPI:1699023598
Name:BIRNBAUM, ABIGAIL
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:
Last Name:BIRNBAUM
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ABI
Other - Middle Name:
Other - Last Name:KURZER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:475 W 186TH ST
Mailing Address - Street 2:APT 4C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-2903
Mailing Address - Country:US
Mailing Address - Phone:917-991-2430
Mailing Address - Fax:
Practice Address - Street 1:1273 53RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3865
Practice Address - Country:US
Practice Address - Phone:718-435-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY089953-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker