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General NPI Number Information
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NPI Number | 1235789611
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Entity Type | Organization
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Legal Business Name | ELAINE YUDKOVITZ PHD LCSW PLLC
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Dates
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Enumeration Date | 09/17/2019
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 80 8TH AVE STE 1605
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City | NEW YORK
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State | NY
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Zip | 10011-7154
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Country | US
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Telephone | 212-989-3689
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Fax |
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Provider Business Mailing Address
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Address Line | 80 8TH AVE STE 1605
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City | NEW YORK
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State | NY
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Zip | 10011-7154
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Country | US
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Telephone | 212-989-3689
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELAINE YUDKOVITZ
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Credential | PHD, LCSW
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Telephone | 212-989-3689
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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 |
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License Number State |
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