Provider Demographics
NPI:1467533539
Name:ROCKOFF, JONAH III
Entity Type:Individual
Prefix:
First Name:JONAH
Middle Name:
Last Name:ROCKOFF
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:YONAH
Other - Middle Name:
Other - Last Name:ROCKOFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:76-03 169TH STREET
Mailing Address - Street 2:
Mailing Address - City:FLUSHING, QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11366
Mailing Address - Country:US
Mailing Address - Phone:718-969-3243
Mailing Address - Fax:
Practice Address - Street 1:1670-78 EAST 17TH STREET
Practice Address - Street 2:2ND. FL.
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:718-375-1200
Practice Address - Fax:718-382-3358
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0542241104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN6H 911Medicare ID - Type Unspecified