Provider Demographics
NPI:1386936565
Name:NYER, DAVID JONATHAN (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JONATHAN
Last Name:NYER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 MANSFIELD ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2643
Mailing Address - Country:US
Mailing Address - Phone:718-813-2682
Mailing Address - Fax:
Practice Address - Street 1:500 NEW HEMPSTEAD RD
Practice Address - Street 2:SUITE D
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-1132
Practice Address - Country:US
Practice Address - Phone:718-813-2682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-06
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0836171041C0700X
NY0804981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical