Individual
ASHISH PETHANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7558 113TH ST, SUITE 1A, FOREST HILLS, NY 11375-2204
(718) 268-9595
(718) 268-9528
Mailing address
50 RUSSELL ST, ROSLYN HEIGHTS, NY 11577-1342
(718) 268-9595
(718) 268-9528
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
079527
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079527
LICENSE #
NY
Enumeration date
06/21/2012
Last updated
06/21/2012
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