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General NPI Number Information
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NPI Number | 1972500916
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Entity Type | Individual
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Provider Name | MARVIN A. YUDKOVITZ MSW
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Gender | Male
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Dates
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Enumeration Date | 07/06/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | NAT. NAVAL MED. CTR., 8901 WISCONSIN AVE. BUILDING 7, ROOM 3104
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City | BETHESDA
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State | MD
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Zip | 20889-0001
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Country | US
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Telephone | 301-295-2478
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Fax | 301-295-6720
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Provider Business Mailing Address
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Address Line | NATIONAL NAVAL MEDICAL CENTER 8901 WISCONSIN AVENUE, BLDG. 7, ROOM 3104
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City | BETHESDA
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State | MD
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Zip | 20889-5600
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Country | US
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Telephone | 301-295-2478
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 07035
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC300758
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License Number State | DC
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