Provider Demographics
NPI:1154452043
Name:PEKOWSKY, JUDITH CAROL (MSW)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:CAROL
Last Name:PEKOWSKY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 W END AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 RIVERSIDE DR
Practice Address - Street 2:SUITE 3Y
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2504
Practice Address - Country:US
Practice Address - Phone:212-877-1753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0021311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical