Basic Information
| Provider Information | |||||||||
| NPI: | 1306902085 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZARETSKY | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 92 HESS RD | ||||||||
| Address2: | |||||||||
| City: | VALLEY COTTAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109892219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144234433 | ||||||||
| FaxNumber: | 9144239434 | ||||||||
| Practice Location | |||||||||
| Address1: | 92 HESS RD | ||||||||
| Address2: | |||||||||
| City: | VALLEY COTTAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109892219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144234433 | ||||||||
| FaxNumber: | 9144239434 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2006 | ||||||||
| LastUpdateDate: | 10/17/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | R039384 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 341014 | 01 | NY | HEALTHNET | OTHER |