Provider Demographics
NPI:1922319920
Name:FIERSTEIN, ROB M (LCSW)
Entity Type:Individual
Prefix:
First Name:ROB
Middle Name:M
Last Name:FIERSTEIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:ROB
Other - Middle Name:
Other - Last Name:FIERSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1133 BROADWAY
Mailing Address - Street 2:SUITE 1127
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7903
Mailing Address - Country:US
Mailing Address - Phone:917-685-4333
Mailing Address - Fax:
Practice Address - Street 1:1133 BROADWAY
Practice Address - Street 2:SUITE 1127
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7903
Practice Address - Country:US
Practice Address - Phone:917-685-4333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0595891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1922319920OtherCHILD AND ADOLESCENT PSYCHOANALYTIC PSYCHOTHERAPY