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NPI Code Detail

MEDICARE: FRAIDA YUDKOWSKY LSW, LMSW, ACSW

MEDICARE: FRAIDA YUDKOWSKY LSW, LMSW, ACSW
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
1104100000XSocial Worker44SL06122400NJ

Other Identifiers

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

General Provider Information

NPI Number : 1245713957
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRAIDA YUDKOWSKY LSW, LMSW, ACSW
Provider Business Mailing Address
First Line : 114 MILLER RD APT A
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-2332
Country : US
Telephone Number : 732-948-4636
Fax Number :
Provider Business Practice Location Address
First Line : 725 AIRPORT RD
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-5968
Country : US
Telephone Number : 732-458-1700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2018
Last Update Date : 09/09/2018

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