Civin, Michael A

Civin, Michael A is an sole proprietor health care provider with primary practice located at 696 E 187Th St 205-208, Bronx NY 10458-6800. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychoanalyst, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Civin, Michael A can be contacted via phone (516) 641-6358.

Contact Information

Primary practice address
696 E 187Th St 205-208 Bronx NY 10458-6800
Phone: (516) 641-6358
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychoanalyst 102L00000X
Behavioral Health & Social Service Providers / Clinical 103TC0700X 010129 New York

Profile Details

NPI number 1265655419
LBN Legal business name Civin, Michael A
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 10th, 2007
Last updated Jan 3rd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265655419 NPPES
New York MEDICAID 01174941

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