Pablo Idez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P063837-1 Issued in NY

Practice address

97 Powerhouse Rd Ste 104
Roslyn Heights, NY 11577-2046

Phone

(347) 772-8373

Fax

(718) 225-9201

NPI assigned

Feb 17, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607817600000",
    "number": "1952540833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 DALTON LN",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313909",
            "telephone_number": "347-772-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 POWERHOUSE RD STE 104",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772046",
            "telephone_number": "347-772-8373",
            "fax_number": "718-225-9201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 Woodbury Rd",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "NY",
            "postal_code": "117971411",
            "country_code": "US",
            "telephone_number": "347-772-8373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDEZ",
        "first_name": "PABLO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-17",
        "last_updated": "2020-12-13",
        "certification_date": "2020-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "P063837-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carole Hofstein Hofstein-Amselem
• Stephanie Jill Horowitz, RDN, CDN
• MD Abul Hussain
• Stephen Ira Hyman, PH.D.
• Lilia Idanan, MD
• Barbara Nan Ilowite, LMHC
• John E. Imhof
• Institute for Emotional Health
• Internal Medicine Associates of East Hills,LLP
• Marisa Ip, M.D.

• Clinical Social Worker in Roslyn Heights, NY
• Providers in Roslyn Heights, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.