Provider Demographics
NPI:1346729787
Name:NITTENBERG, DANIELA (LCAT)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:NITTENBERG
Suffix:
Gender:F
Credentials:LCAT
Other - Prefix:DR
Other - First Name:DANIELA
Other - Middle Name:
Other - Last Name:NITTENBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCAT
Mailing Address - Street 1:838 W END AVE APT 9A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5367
Mailing Address - Country:US
Mailing Address - Phone:917-373-8194
Mailing Address - Fax:
Practice Address - Street 1:1268 E 14TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5241
Practice Address - Country:US
Practice Address - Phone:718-382-0045
Practice Address - Fax:718-382-0051
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP11385221700000X
NY002538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist