MEDICARE: ROBERT JUDEM-CAUTIN I LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	R34919	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013089135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT JUDEM-CAUTIN I LCSW

Provider Business Mailing Address
First Line	:	70 E 10TH ST APT 20G
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-5120
Country	:	US
Telephone Number	:	917-880-2142
Fax Number	:

Provider Business Practice Location Address
First Line	:	514 49TH ST
Second Line	:	LUTHERAN HOSPITAL
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2010
Country	:	US
Telephone Number	:	718-431-2641
Fax Number	:	718-437-5239

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	10/15/2008

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