Provider Demographics
NPI:1770662777
Name:LOZENTSVAK, LEONID (LCSW)
Entity Type:Individual
Prefix:MR
First Name:LEONID
Middle Name:
Last Name:LOZENTSVAK
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 1:2435 HARING ST
Mailing Address - Street 2:APT. 6F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1866
Mailing Address - Country:US
Mailing Address - Phone:718-769-7308
Mailing Address - Fax:
Practice Address - Street 1:1670-78 EAST 17TH STREET
Practice Address - Street 2:3RD FL.
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:718-375-1200
Practice Address - Fax:718-382-3358
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07274611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNH5531Medicare ID - Type Unspecified