Provider Demographics
NPI:1396432050
Name:ZECHORY, ILAN (LMSW)
Entity type:Individual
Prefix:
First Name:ILAN
Middle Name:
Last Name:ZECHORY
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 1:204 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-1709
Mailing Address - Country:US
Mailing Address - Phone:248-515-6609
Mailing Address - Fax:
Practice Address - Street 1:260 W 72ND ST APT 11B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2822
Practice Address - Country:US
Practice Address - Phone:248-515-6609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0982841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical