Basic Information
| Provider Information | |||||||||
| NPI: | 1154629327 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RZEWINSKI | ||||||||
| FirstName: | JUSTYNA | ||||||||
| MiddleName: | MARIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6225 84TH ST APT C31 | ||||||||
| Address2: | MIDDLE VILLAGE | ||||||||
| City: | MIDDLE VILLAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113792000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3478603878 | ||||||||
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| Practice Location | |||||||||
| Address1: | 250 NEPTUNE AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112356302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187690405 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2011 | ||||||||
| LastUpdateDate: | 03/11/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 083016 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.