Provider Demographics
NPI:1801905658
Name:RUDOVSKY, ANN (LCSW)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:RUDOVSKY
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 1:2 W 67TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6241
Mailing Address - Country:US
Mailing Address - Phone:212-769-0504
Mailing Address - Fax:212-580-6954
Practice Address - Street 1:2 W 67TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6241
Practice Address - Country:US
Practice Address - Phone:212-769-0504
Practice Address - Fax:212-580-6954
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO103451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical