Provider Demographics
NPI:1851922868
Name:ZUCKERMAN SHARE, LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:
Last Name:ZUCKERMAN SHARE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 W END AVE APT 7A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7355
Mailing Address - Country:US
Mailing Address - Phone:917-312-1386
Mailing Address - Fax:
Practice Address - Street 1:251 CENTRAL PARK W APT 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4111
Practice Address - Country:US
Practice Address - Phone:917-312-1386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001057-01103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis