Doctor Name: | MR. STEVEN GERALD RUTTER |
NPI Number: | 1003839895 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW |
License Number: | LCSW PRO23427-1 |
Business Practice Address: | 22 Milford Dr Plainview, NY - 118033233 |
Business Phone Number: | 5169356608 |
Business Fax Number: | 5165052011 |
Mailing Address: | 22 Milford Dr, PLAINVIEW |
State: | NY |
Postal Code: | 118033233 |
Phone Number: | 5169356608 |
Fax Number: | 5165052011 |
NPI Enumeration Date: | 07/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LCSW PRO23427-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |