Provider Demographics
NPI:1770566457
Name:HUFNAGEL, ROBERTA (LCSW)
Entity type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:
Last Name:HUFNAGEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 E 81ST ST
Mailing Address - Street 2:7F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1880
Mailing Address - Country:US
Mailing Address - Phone:212-744-6572
Mailing Address - Fax:
Practice Address - Street 1:151 E 81ST ST
Practice Address - Street 2:7F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-1848
Practice Address - Country:US
Practice Address - Phone:212-744-6572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03013111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0045547OtherGHI
NYN49631OtherEMPIRE BLUE CROSS BLUE SH
NYDR7735OtherOXFORD
NYN49631Medicare UPIN