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NPI Code Detail

MEDICARE: RODA NEUGEBAUER L.C.S.W.

MEDICARE:   RODA  NEUGEBAUER  L.C.S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerPR013643-1NY

General Provider Information

NPI Number : 1710183900
Entity Type Code : Individual
Provider Name (Legal Business Name) : RODA NEUGEBAUER L.C.S.W.
Provider Business Mailing Address
First Line : 1 BANK ST APT 5B
Second Line :
City : NEW YORK
State : NY
Zip : 10014-5210
Country : US
Telephone Number : 212-989-1959
Fax Number :
Provider Business Practice Location Address
First Line : 31 W 10TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10011-8738
Country : US
Telephone Number : 212-253-2494
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2007
Last Update Date : 07/08/2007

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Directions to “ RODA NEUGEBAUER L.C.S.W.” Practice Location

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