Provider Demographics
NPI:1972667574
Name:NAISTETER, PAULINA ZEL (MSW LCSW)
Entity Type:Individual
Prefix:
First Name:PAULINA
Middle Name:ZEL
Last Name:NAISTETER
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:PAULINA
Other - Middle Name:
Other - Last Name:ZEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:835 LAWLER STREET
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116
Mailing Address - Country:US
Mailing Address - Phone:267-254-2618
Mailing Address - Fax:215-673-5240
Practice Address - Street 1:8018 BUSTLETON AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152
Practice Address - Country:US
Practice Address - Phone:267-254-2618
Practice Address - Fax:215-673-5240
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0126041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
2080440OtherCIGNA
PAMA01967498Medicaid
23005800OtherMAGELLAN
NA039701Medicare ID - Type Unspecified