Individual
DR. CAROL MARCIA POTRUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, PHD
Contact information
Practice address
1527 FRANKLIN AVE, SUITE 203, MINEOLA, NY 11501-4827
(516) 317-1493
(212) 744-0696
Mailing address
220 E 67TH ST, NEW YORK, NY 10021-6255
(516) 317-1493
(212) 744-0696
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R040274-1
NY
Other
Enumeration date
10/27/2006
Last updated
07/08/2007
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