Ann M Rudolph is a Clinical in Port Jefferson, New York. Ann M Rudolph practices all healthcare services and medical treatments related to Clinical. The NPI Number for Ann M Rudolph is 1417013723. The last update date is 2007-07-08.
Ann M Rudolph's current location address is 1000 Main St, Port Jefferson, New York. You can contact this provider via phone number 6313314458. The mailing address for Ann M Rudolph is 1000 Main St, Port Jefferson, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ann M Rudolph |
|---|---|
| Address | 1000 Main St, Port Jefferson, New York |
| Phone Number | 6313314458 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | L-CSW-R |
NPI Number Detail
| NPI Number | 1417013723 |
|---|---|
| Provider Enumeration Date | 2006-12-29 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1000 Main St |
|---|---|
| City | Port Jefferson |
| State | New York (NY) |
| Post Code | 117772250 |
| Phone Number | 6313314458 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | R037202-1 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5169741 | NY | AETNA | |
| P1626359 | NY | OXFORD | |
| 71480 | NY | VALUE OPTIONS | |
| 7404242 | NY | GHI | |
| 13690 | NY | VYTRA |
Post Comment/ Review Below
What is the unique identification code assigned to Ann M Rudolph by the Centers for Medicare & Medicaid Services?
The Ann M Rudolph has been issued the NPI (National Provider Identifier) 1417013723. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Ann M Rudolph is geographically located?
The Ann M Rudolph is physically situated at the following location: 1000 Main St, Port Jefferson, NY, 117772250.
What is Ann M Rudolph's area of expertise and its corresponding taxonomy classification?
The Ann M Rudolph's field of specialization is Clinical, and it falls under the taxonomy code 1041C0700X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services assign the 1417013723 to Ann M Rudolph?
The Centers for Medicare & Medicaid Services assigned the 1417013723 to Ann M Rudolph on 2006-12-29.
As of what date were the Ann M Rudolph's details last updated?
The information pertaining to the Ann M Rudolph, including its address, specialty, and other details, was most recently updated on 2007-07-08.