Provider Demographics
NPI:1508922170
Name:ROKOFSKY, JUDITH MARINA (RN,LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:MARINA
Last Name:ROKOFSKY
Suffix:
Gender:F
Credentials:RN,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ABBEY LN
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-3002
Mailing Address - Country:US
Mailing Address - Phone:516-822-8064
Mailing Address - Fax:516-822-7690
Practice Address - Street 1:11 ABBEY LN
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-3002
Practice Address - Country:US
Practice Address - Phone:516-822-8064
Practice Address - Fax:516-822-7690
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0484141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN7M571Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER