Provider Demographics
NPI:1790327534
Name:RUDOFSKY, EMILY (LCSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:RUDOFSKY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-3419
Mailing Address - Country:US
Mailing Address - Phone:732-470-0272
Mailing Address - Fax:
Practice Address - Street 1:842 DURHAM RD STE 200
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-9680
Practice Address - Country:US
Practice Address - Phone:732-470-0272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-14
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCO6108001041C0700X
NJ44SL065139001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical