Provider Demographics
NPI:1952429490
Name:ABOULAFIA, MATTHEW MARTIN (MSW)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:MARTIN
Last Name:ABOULAFIA
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 E 42ND ST RM 1407
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5404
Mailing Address - Country:US
Mailing Address - Phone:212-682-3382
Mailing Address - Fax:212-682-3382
Practice Address - Street 1:51 E 42ND ST RM 1407
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5404
Practice Address - Country:US
Practice Address - Phone:212-682-3382
Practice Address - Fax:212-682-3382
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0313161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01504301Medicaid
NY01504301Medicaid