Basic Information
| Provider Information | |||||||||
| NPI: | 1467533539 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROCKOFF | ||||||||
| FirstName: | JONAH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | III | ||||||||
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| OtherOrganizationName: | |||||||||
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| OtherLastName: | ROCKOFF | ||||||||
| OtherFirstName: | YONAH | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | LCSW | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 76-03 169TH STREET | ||||||||
| Address2: | |||||||||
| City: | FLUSHING, QUEENS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189693243 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1670-78 EAST 17TH STREET | ||||||||
| Address2: | 2ND. FL. | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183751200 | ||||||||
| FaxNumber: | 7183823358 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2006 | ||||||||
| LastUpdateDate: | 02/10/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | R0542241 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.