Provider Demographics
NPI:1770977183
Name:DAVID J NYER LCSW PC
Entity type:Organization
Organization Name:DAVID J NYER LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JONATHAN
Authorized Official - Last Name:NYER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-813-2682
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty