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General NPI Number Information
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NPI Number | 1972134781
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Entity Type | Individual
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Provider Name | MARILYN ISABELLA RUKAJ LMHC
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Gender | Female
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Dates
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Enumeration Date | 01/30/2020
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 260 MADISON AVE FL 8
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City | NEW YORK
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State | NY
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Zip | 10016-2418
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Country | US
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Telephone | 212-335-0511
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Fax |
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Provider Business Mailing Address
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Address Line | 17 ARCADIAN WAY STE 200
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City | PARAMUS
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State | NJ
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Zip | 07652-1245
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Country | US
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Telephone | 551-655-7012
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P104056
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 012933
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License Number State | NY
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