| Sally Rudnick, Lcsw, Pllc | |
|
28 Railroad Ave Warwick NY 10990-1639 | |
| (917) 656-9439 | |
| Not Available |
| Full Name | Sally Rudnick, Lcsw, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 28 Railroad Ave, Warwick, New York |
| Authorized Official Name and Position | Sally Rudnick (OWNER) |
| Authorized Official Contact | 9176569439 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sally Rudnick, Lcsw, Pllc 28 Railroad Ave Warwick NY 10990-1639 Ph: (917) 656-9439 | Sally Rudnick, Lcsw, Pllc 28 Railroad Ave Warwick NY 10990-1639 Ph: (917) 656-9439 |
| NPI Number | 1326624792 |
|---|---|
| Provider Enumeration Date | 03/24/2021 |
| Last Update Date | 03/31/2021 |
| Certification Date | 03/31/2021 |
| Medicare PECOS PAC ID | 0345657532 |
|---|---|
| Medicare Enrollment ID | O20210406002213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326624792 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Sally S Rudnick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386979045 PECOS PAC ID: 7012179708 Enrollment ID: I20120425000352 |
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