Provider Demographics
NPI:1750441911
Name:DZALDOV, NAOMI RUTH (LMSW)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:RUTH
Last Name:DZALDOV
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 1:666 W END AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7357
Mailing Address - Country:US
Mailing Address - Phone:718-729-0808
Mailing Address - Fax:718-729-9139
Practice Address - Street 1:83 MAIDEN LANE
Practice Address - Street 2:AHRC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038
Practice Address - Country:US
Practice Address - Phone:718-729-0808
Practice Address - Fax:718-729-9139
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070234104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker