| Doctor Name: | ROBERT VICHNIS |
| NPI Number: | 1184823130 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.C.S.W. |
| License Number: | 069238-1 |
| Business Practice Address: | 2850 N Jerusalem Rd Wantagh, NY - 117931125 |
| Business Phone Number: | 5163962661 |
| Business Fax Number: | |
| Mailing Address: | 405 9th St, BROOKLYN |
| State: | NY |
| Postal Code: | 112154101 |
| Phone Number: | 3476838912 |
| Fax Number: | |
| NPI Enumeration Date: | 07/11/2007 |
| NPI Last Update Date: | 11/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 069238-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |