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General NPI Number Information
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NPI Number | 1528494895
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Entity Type | Individual
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Provider Name | MARJORIE ROOP L.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 09/18/2013
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | 164 W 80TH ST
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City | NEW YORK
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State | NY
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Zip | 10024-6357
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Country | US
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Telephone | 917-562-7897
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Fax |
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Provider Business Mailing Address
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Address Line | 164 W. 80TH ST. COGNITIVE HEALTH GROUP
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City | NEW YORK
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State | NY
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Zip | 10024
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Country | US
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Telephone | 917-562-7897
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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 | 074147
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License Number State | NY
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