Healthcare Provider Details

I. General information

NPI: 1225199649
Provider Name (Legal Business Name): BARBARA CAJDLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6526 75TH PL
MIDDLE VILLAGE NY
11379-1824
US

IV. Provider business mailing address

6526 75TH PL
MIDDLE VILLAGE NY
11379-1824
US

V. Phone/Fax

Practice location:
  • Phone: 718-326-3427
  • Fax: 718-416-1772
Mailing address:
  • Phone: 718-326-3427
  • Fax: 718-416-1772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR056250
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: