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General NPI Number Information
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NPI Number | 1700431327
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Entity Type | Individual
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Provider Name | RACHEL JUDITH WISS MSW
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Gender | Male
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Dates
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Enumeration Date | 08/09/2019
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Last Update Date | 08/09/2019
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Provider Practice Location Address
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Address Line | 302 5TH AVE STE 807
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City | NEW YORK
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State | NY
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Zip | 10001-3604
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Country | US
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Telephone | 347-418-6589
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Fax |
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Provider Business Mailing Address
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Address Line | 3424 82ND ST APT 6I
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-2914
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Country | US
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Telephone | 347-418-6589
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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