Provider Demographics
NPI:1811911456
Name:TROJANOWSKI, ROMAN-DAVID (LCSW)
Entity type:Individual
Prefix:
First Name:ROMAN-DAVID
Middle Name:
Last Name:TROJANOWSKI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 EAST 36TH STREET.
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:MANHATTAN
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3449
Mailing Address - Country:US
Mailing Address - Phone:347-401-1559
Mailing Address - Fax:212-685-0284
Practice Address - Street 1:36 EAST 36TH STREET
Practice Address - Street 2:SUITE 3B
Practice Address - City:MANHATTAN
Practice Address - State:NY
Practice Address - Zip Code:10016-3449
Practice Address - Country:US
Practice Address - Phone:347-401-1559
Practice Address - Fax:212-685-0284
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR06117911041C0700X
NJ44SC05448801041C0700X
NY06117911041C0700X
FLSW80441041C0700X
CT05S7601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02147148Medicaid