Provider Demographics
NPI:1336739184
Name:BRUH, DANIEL (LMSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:BRUH
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E 66TH ST APT 9F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6235
Mailing Address - Country:US
Mailing Address - Phone:516-384-8798
Mailing Address - Fax:
Practice Address - Street 1:333 E 66TH ST APT 9F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6235
Practice Address - Country:US
Practice Address - Phone:516-384-8798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111410104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker