Provider Demographics
NPI:1891915260
Name:ZUCKER, JONATHAN STUART (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:STUART
Last Name:ZUCKER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E 44TH ST
Mailing Address - Street 2:SUITE 312
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4422
Mailing Address - Country:US
Mailing Address - Phone:914-393-8700
Mailing Address - Fax:
Practice Address - Street 1:310 E 44TH ST
Practice Address - Street 2:SUITE 312
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4422
Practice Address - Country:US
Practice Address - Phone:914-393-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
102L00000X
NY071140104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker