Healthcare Provider Details

I. General information

NPI: 1518740794
Provider Name (Legal Business Name): MAGDALENA WOJDAKOWSKA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7706 13TH AVE STE 2
BROOKLYN NY
11228-2414
US

IV. Provider business mailing address

7706 13TH AVE STE 2
BROOKLYN NY
11228-2414
US

V. Phone/Fax

Practice location:
  • Phone: 718-232-8600
  • Fax:
Mailing address:
  • Phone: 718-232-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number116202
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: