Provider Demographics
NPI:1194871756
Name:SAFIRSTEIN, ANDREA BETH (PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:BETH
Last Name:SAFIRSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 W 72ND ST
Mailing Address - Street 2:5E3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3204
Mailing Address - Country:US
Mailing Address - Phone:917-744-9698
Mailing Address - Fax:212-874-7230
Practice Address - Street 1:117 W 72ND ST
Practice Address - Street 2:5E3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3204
Practice Address - Country:US
Practice Address - Phone:917-744-9698
Practice Address - Fax:212-874-7230
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015670103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY337274OtherMHN
NYP3027003OtherOXFORD