Provider Demographics
NPI:1124163746
Name:FURCHT, PAMELA ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANN
Last Name:FURCHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 7TH ST
Mailing Address - Street 2:STE 300
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5747
Mailing Address - Country:US
Mailing Address - Phone:516-873-0217
Mailing Address - Fax:
Practice Address - Street 1:233 7TH ST
Practice Address - Street 2:STE 300
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5747
Practice Address - Country:US
Practice Address - Phone:516-873-0217
Practice Address - Fax:516-826-5729
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03662311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N5754ZMedicare ID - Type Unspecified