Provider Demographics
NPI:1982214789
Name:MALITZ, CHRISTIE-LYNN (MSW)
Entity Type:Individual
Prefix:
First Name:CHRISTIE-LYNN
Middle Name:
Last Name:MALITZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HEARD RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMING GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:10914-5014
Mailing Address - Country:US
Mailing Address - Phone:914-396-5649
Mailing Address - Fax:
Practice Address - Street 1:3136 NY ROUTE 207
Practice Address - Street 2:
Practice Address - City:CAMPBELL HALL
Practice Address - State:NY
Practice Address - Zip Code:10916
Practice Address - Country:US
Practice Address - Phone:855-771-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty