Provider Demographics
NPI:1336204775
Name:HOLLANDER, CHARLOTTE RENEE (SOCIAL WORKER)
Entity Type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:RENEE
Last Name:HOLLANDER
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 VALENTINE DR
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-2222
Mailing Address - Country:US
Mailing Address - Phone:516-873-8710
Mailing Address - Fax:516-873-8709
Practice Address - Street 1:10 VALENTINE DR
Practice Address - Street 2:
Practice Address - City:ALBERTSON
Practice Address - State:NY
Practice Address - Zip Code:11507-2222
Practice Address - Country:US
Practice Address - Phone:516-873-8710
Practice Address - Fax:516-873-8709
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR015984-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN25422Medicare ID - Type UnspecifiedLICENSED SOCIAL WORKER