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General NPI Number Information
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NPI Number | 1548345986
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Entity Type | Individual
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Provider Name | GAIL A VODOPIJA LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 02/20/2015
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Provider Practice Location Address
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Address Line | 755 WAVERLY AVE SUITE 305
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City | HOLTSVILLE
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State | NY
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Zip | 11742-1190
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Country | US
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Telephone | 631-721-7422
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Fax | 631-803-0394
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Provider Business Mailing Address
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Address Line | 77 CEDARHURST AVE
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City | SELDEN
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State | NY
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Zip | 11784-2907
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Country | US
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Telephone | 631-721-7422
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Fax | 631-803-0394
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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 | R-071721-1
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License Number State | NY
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