Provider Demographics
NPI:1306052717
Name:GERMAN, PATTI KALECK (MED,LMFT)
Entity type:Individual
Prefix:MS
First Name:PATTI
Middle Name:KALECK
Last Name:GERMAN
Suffix:
Gender:F
Credentials:MED,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W 63RD ST
Mailing Address - Street 2:28T
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 W 63RD ST
Practice Address - Street 2:28T
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7103
Practice Address - Country:US
Practice Address - Phone:212-582-6056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY81106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist