Provider Demographics
NPI:1265736292
Name:PANEK, DEBRA ANN (LMSW)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ANN
Last Name:PANEK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 BROADWAY FL 17
Mailing Address - Street 2:VISITING NURSE SERVICE OF NY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3701
Mailing Address - Country:US
Mailing Address - Phone:212-609-6257
Mailing Address - Fax:212-279-1119
Practice Address - Street 1:1250 BROADWAY FL 17
Practice Address - Street 2:VISITING NURSE SERVICE OF NY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3701
Practice Address - Country:US
Practice Address - Phone:212-609-6257
Practice Address - Fax:212-279-1119
Is Sole Proprietor?:No
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071675-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker