MEDICARE: ANN RUDOVSKY 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
1	1041C0700X	Clinical Social Worker	PRO10345	NY

General Provider Information

NPI Number	:	1801905658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN RUDOVSKY L.C.S.W.

Provider Business Mailing Address
First Line	:	2 W 67TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-6241
Country	:	US
Telephone Number	:	212-769-0504
Fax Number	:	212-580-6954

Provider Business Practice Location Address
First Line	:	2 W 67TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-6241
Country	:	US
Telephone Number	:	212-769-0504
Fax Number	:	212-580-6954

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	05/25/2022

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Directions to “ ANN RUDOVSKY L.C.S.W.” Practice Location

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