Provider Demographics
NPI:1205423753
Name:RABINOWITZ, SALLY L ENFIELD (LCAT)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:L ENFIELD
Last Name:RABINOWITZ
Suffix:
Gender:F
Credentials:LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 MADISON AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5153
Mailing Address - Country:US
Mailing Address - Phone:917-623-3846
Mailing Address - Fax:
Practice Address - Street 1:171 MADISON AVE STE 400
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5153
Practice Address - Country:US
Practice Address - Phone:917-623-3846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY002811221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health