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General NPI Number Information
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NPI Number | 1821141755
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Entity Type | Individual
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Provider Name | CATHERINE A PUTKOWSKI-O'BRIEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 11/14/2021
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Provider Practice Location Address
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Address Line | 2336 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2346
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Country | US
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Telephone | 718-351-3030
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Fax | 718-442-6940
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Provider Business Mailing Address
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Address Line | PO BOX 140440
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City | STATEN ISLAND
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State | NY
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Zip | 10314-0440
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Country | US
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Telephone | 917-885-8967
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Fax | 718-273-3245
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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 | R028848-1
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License Number State | NY
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