Healthcare Provider Details

I. General information

NPI: 1841114113
Provider Name (Legal Business Name): SARA RUKEYSER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 PINE ST
KINGSTON NY
12401-4948
US

IV. Provider business mailing address

532 LEFFERTS AVE APT 6J
BROOKLYN NY
11225-4557
US

V. Phone/Fax

Practice location:
  • Phone: 844-434-2778
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number132155
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: