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General NPI Number Information
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NPI Number | 1992039374
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Entity Type | Individual
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Provider Name | MS. TRUDIE CAROL PASS
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Gender | Female
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Dates
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Enumeration Date | 10/01/2009
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Last Update Date | 10/01/2009
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Provider Practice Location Address
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Address Line | 225 LINCOLN PLACE, APT #1F
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City | BROOKLYN
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State | NY
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Zip | 11217-3726
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Country | US
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Telephone | 718-399-7717
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Fax | 718-300-7717
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Provider Business Mailing Address
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Address Line | 225 LINCOLN PLACE, APT #1F
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City | BROOKLYN
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State | NY
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Zip | 11217-3726
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Country | US
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Telephone | 718-399-7717
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Fax | 718-300-7717
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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 | RO19749-1
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License Number State | NY
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