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Individual

AMY ABIGAIL ELLENBOGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.W.

Contact information

Practice address
175 E 94TH ST, NEW YORK, NY 10128-2905
(917) 674-3421
Mailing address
454 56TH ST, BROOKLYN, NY 11220-3409
(718) 965-1650

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
063049
NY

Other

Enumeration date
11/03/2021
Last updated
11/03/2021
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