Provider Demographics
NPI:1053206987
Name:FODOR, ROXANA LAURA (MSW, MSC)
Entity type:Individual
Prefix:
First Name:ROXANA
Middle Name:LAURA
Last Name:FODOR
Suffix:
Gender:F
Credentials:MSW, MSC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:FODOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, MSC
Mailing Address - Street 1:635 W 42ND ST APT 39D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-1936
Mailing Address - Country:US
Mailing Address - Phone:587-216-7633
Mailing Address - Fax:
Practice Address - Street 1:575 W END AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2711
Practice Address - Country:US
Practice Address - Phone:917-727-0717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker