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General NPI Number Information
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NPI Number | 1205150752
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Entity Type | Individual
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Provider Name | SUSAN KADAVIL
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Gender | Female
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Dates
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Enumeration Date | 03/25/2010
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Last Update Date | 03/25/2010
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Provider Practice Location Address
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Address Line | 15 W 65TH ST
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City | NEW YORK
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State | NY
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Zip | 10023-6601
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Country | US
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Telephone | 917-386-9062
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Fax |
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Provider Business Mailing Address
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Address Line | 24 PLAINVIEW AVE
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City | ARDSLEY
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State | NY
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Zip | 10502-1919
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Country | US
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Telephone | 914-478-2413
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R0460921
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License Number State | NY
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