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Individual

IRIS SUGARMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
103 E 86TH ST, 12C, NEW YORK, NY 10028
(212) 828-4459
Mailing address
103 E 86TH ST, 12C, NEW YORK, NY 10028-1058
(212) 828-4459

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
R009289
NY
103TP0814X
Psychoanalysis Psychologist
R009289
NY
104100000X
Social Worker
R009289
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0096565
GHI
NY
01
113475
VALUE OPTIONS
NY
Enumeration date
12/18/2006
Last updated
03/14/2008
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