Provider Demographics
NPI:1972773273
Name:GIRGIS, IHAB (LCSW)
Entity Type:Individual
Prefix:MR
First Name:IHAB
Middle Name:
Last Name:GIRGIS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 INGRAHAM LN
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4240
Mailing Address - Country:US
Mailing Address - Phone:917-648-0885
Mailing Address - Fax:
Practice Address - Street 1:210 INGRAHAM LN
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-4240
Practice Address - Country:US
Practice Address - Phone:917-648-0885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0758271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical