Provider Demographics
NPI:1699971754
Name:PRIMACK, SABINA KAYE (LCSW, PHD)
Entity type:Individual
Prefix:DR
First Name:SABINA
Middle Name:KAYE
Last Name:PRIMACK
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CENTRAL PARK W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4250
Mailing Address - Country:US
Mailing Address - Phone:917-364-8403
Mailing Address - Fax:212-769-2931
Practice Address - Street 1:101 CENTRAL PARK W
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4250
Practice Address - Country:US
Practice Address - Phone:917-364-8403
Practice Address - Fax:212-769-2931
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR030494-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N51241Medicare ID - Type Unspecified