Provider Demographics
NPI:1700965605
Name:OBSTFELD, RENEE (LCAT, NCPSYA, LP)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:
Last Name:OBSTFELD
Suffix:
Gender:F
Credentials:LCAT, NCPSYA, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY PL
Mailing Address - Street 2:#10-P
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4518
Mailing Address - Country:US
Mailing Address - Phone:917-612-2863
Mailing Address - Fax:
Practice Address - Street 1:31 WASHINGTON SQ W # 3RC
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-9126
Practice Address - Country:US
Practice Address - Phone:917-612-2863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05 000209221700000X
NY000899102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist