Provider Demographics
NPI:1134239833
Name:BLUMFARB, HENRY JOSHUA (LCSW)
Entity type:Individual
Prefix:MR
First Name:HENRY
Middle Name:JOSHUA
Last Name:BLUMFARB
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 1:185 WEST END AVE
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-877-1084
Mailing Address - Fax:212-877-1084
Practice Address - Street 1:185 WEST END AVE
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023
Practice Address - Country:US
Practice Address - Phone:212-877-1084
Practice Address - Fax:212-877-1084
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
R176381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN04431Medicare ID - Type Unspecified