Provider Demographics
NPI:1174745749
Name:CIMORELLI, NICHOLAS FRANK (MSW)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:FRANK
Last Name:CIMORELLI
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CHARLES STREET
Mailing Address - Street 2:4E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-3013
Mailing Address - Country:US
Mailing Address - Phone:212-647-0096
Mailing Address - Fax:
Practice Address - Street 1:15 CHARLES STREET
Practice Address - Street 2:4E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-3013
Practice Address - Country:US
Practice Address - Phone:212-647-0096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR029830-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical