Healthcare Provider Details

I. General information

NPI: 1871403444
Provider Name (Legal Business Name): JEANINE M RUFO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 SQUADRON BLVD
NEW CITY NY
10956-5200
US

IV. Provider business mailing address

1 BARGER ST
CORTLANDT MANOR NY
10567-1036
US

V. Phone/Fax

Practice location:
  • Phone: 917-597-9270
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number064356-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: