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General NPI Number Information
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NPI Number | 1447402623
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Entity Type | Individual
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Provider Name | SUSAN DONNA ZAJICEK LMSW
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Gender | Female
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Dates
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Enumeration Date | 10/19/2008
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Last Update Date | 10/19/2008
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Provider Practice Location Address
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Address Line | 28 LYNWOOD RD
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City | CORTLANDT MANOR
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State | NY
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Zip | 10567-5212
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Country | US
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Telephone | 914-736-7371
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Fax | 914-736-9344
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Provider Business Mailing Address
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Address Line | 28 LYNWOOD RD
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City | CORTLANDT MANOR
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State | NY
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Zip | 10567-5212
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Country | US
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Telephone | 914-736-7371
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Fax | 914-736-9344
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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 | 0356211
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License Number State | NY
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