Healthcare Provider Details

I. General information

NPI: 1649630062
Provider Name (Legal Business Name): JFC PROFESSIONAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2016
Last Update Date: 02/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 W 13TH ST SUITE A
NEW YORK NY
10011-7959
US

IV. Provider business mailing address

60 W 13TH ST SUITE A
NEW YORK NY
10011-7959
US

V. Phone/Fax

Practice location:
  • Phone: 212-463-0080
  • Fax: 646-726-4533
Mailing address:
  • Phone: 212-463-0080
  • Fax: 646-726-4533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number73084103
License Number StateNY

VIII. Authorized Official

Name: DR. JUDITH F. CHUSID
Title or Position: CLINICAL DIRECTOR
Credential: PH.D.
Phone: 212-463-0080