Provider Demographics
NPI:1790239846
Name:POZNER, KIMBERLY MICHELE
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MICHELE
Last Name:POZNER
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 1:201 E 87TH ST
Mailing Address - Street 2:APT. 14P
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3203
Mailing Address - Country:US
Mailing Address - Phone:201-321-7645
Mailing Address - Fax:
Practice Address - Street 1:201 E 87TH ST
Practice Address - Street 2:APT. 14P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3203
Practice Address - Country:US
Practice Address - Phone:201-321-7645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-06
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY137230021101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional