Provider Demographics
NPI:1902384829
Name:BIENKOWSKI, NIGH JAMAL
Entity Type:Individual
Prefix:
First Name:NIGH
Middle Name:JAMAL
Last Name:BIENKOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NIGH
Other - Middle Name:JAMAL
Other - Last Name:MANASSAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1301 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3119
Mailing Address - Country:US
Mailing Address - Phone:646-382-7486
Mailing Address - Fax:
Practice Address - Street 1:1301 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3119
Practice Address - Country:US
Practice Address - Phone:212-426-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080922101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health