Provider Demographics
NPI:1760536536
Name:SOMERSTEIN, MARK ZEV (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:ZEV
Last Name:SOMERSTEIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 EAST 84 STREET
Mailing Address - Street 2:2P
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028
Mailing Address - Country:US
Mailing Address - Phone:212-772-9465
Mailing Address - Fax:212-348-4165
Practice Address - Street 1:150 E 84TH ST
Practice Address - Street 2:2P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2031
Practice Address - Country:US
Practice Address - Phone:212-772-9465
Practice Address - Fax:212-348-4165
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0483451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP41212Medicare UPIN
NYN2H421Medicare ID - Type Unspecified