Provider Demographics
NPI:1841589918
Name:LIEFSHITZ, ANASTASIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANASTASIA
Middle Name:
Last Name:LIEFSHITZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 THWAITES PL
Mailing Address - Street 2:APT. 1G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-7922
Mailing Address - Country:US
Mailing Address - Phone:718-515-3389
Mailing Address - Fax:718-515-3389
Practice Address - Street 1:664 THWAITES PL
Practice Address - Street 2:APT 1G
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-7922
Practice Address - Country:US
Practice Address - Phone:718-515-3389
Practice Address - Fax:718-515-3389
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY102858103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical