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General NPI Number Information
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NPI Number | 1588796387
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Entity Type | Individual
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Provider Name | RICHARD JOSEPH KLOSEK M.S.W.
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Gender | Male
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 02/07/2011
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Provider Practice Location Address
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Address Line | 1230 MAMARONECK AVE SUITE 200
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City | WHITE PLAINS
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State | NY
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Zip | 10605-5229
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Country | US
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Telephone | 914-637-9691
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Fax | 914-637-9684
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Provider Business Mailing Address
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Address Line | 1230 MAMARONECK AVE SUITE 200
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City | WHITE PLAINS
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State | NY
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Zip | 10605-5229
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Country | US
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Telephone | 914-637-9691
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Fax | 914-637-9684
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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 | R052316-2
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License Number State | NY
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