Healthcare Provider Details

I. General information

NPI: 1851605380
Provider Name (Legal Business Name): JENNIFER KAHN RUOFF LMSW, MS ED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2010
Last Update Date: 07/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 HIGHLAND LN
IRVINGTON NY
10533-1845
US

IV. Provider business mailing address

89 HIGHLAND LN
IRVINGTON NY
10533-1845
US

V. Phone/Fax

Practice location:
  • Phone: 914-478-3730
  • Fax: 914-478-3730
Mailing address:
  • Phone: 914-478-3730
  • Fax: 914-478-3730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number055583-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: