Healthcare Provider Details

I. General information

NPI: 1508922170
Provider Name (Legal Business Name): JUDITH MARINA ROKOFSKY RN,LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 ABBEY LN
PLAINVIEW NY
11803-3002
US

IV. Provider business mailing address

11 ABBEY LN
PLAINVIEW NY
11803-3002
US

V. Phone/Fax

Practice location:
  • Phone: 516-822-8064
  • Fax: 516-822-7690
Mailing address:
  • Phone: 516-822-8064
  • Fax: 516-822-7690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR048414
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: